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Treatments and drugs
By Mayo Clinic staff
The type of treatment you receive for spinal stenosis may vary, depending on the location of the stenosis and the severity of your signs and symptoms.
Medications
To control pain associated with spinal stenosis, your doctor may prescribe:
- NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) help relieve pain and reduce inflammation. Some NSAIDs, such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve), are available without prescription.
- Muscle relaxants. Medications such as cyclobenzaprine (Amrix, Flexeril) can calm the muscle spasms that sometimes occur with spinal stenosis.
- Antidepressants. Nightly doses of tricyclic antidepressants, such as amitriptyline, can help ease chronic pain.
- Anti-seizure drugs. Some anti-seizure drugs, such as gabapentin (Neurontin, Gralise) and pregabalin (Lyrica), are used to reduce pain caused by damaged nerves.
- Opioids. Drugs such as oxycodone (Oxycontin, Percocet, others) and hydrocodone (Lortab, Vicodin, others) contain substances related to codeine and can be habit-forming.
Therapy
A physical therapist can teach you exercises that may help:
- Build up your strength and endurance
- Maintain the flexibility and stability of your spine
- Improve your balance
Steroid injections
Your nerve roots may become irritated and swollen at the spots where they are being pinched. Injecting a corticosteroid into the space around that constriction can help reduce the inflammation and relieve some of the pressure. However, repeated steroid injections can weaken nearby bones and connective tissue, so only a few injections a year are allowed.
Surgery
Surgery may be considered if:
- More conservative treatments haven't helped
- You're disabled by your symptoms
- You're in good health otherwise
The goal is to relieve the pressure on your spinal cord or nerve roots. For example, a laminectomy removes the back part (lamina) of the affected vertebra to create more room within the spinal canal. In some cases, vertebrae also may need to be fused together to maintain the spine's strength.
In most cases, surgery helps reduce spinal stenosis symptoms. But some people's symptoms stay the same or get worse after surgery. Surgical risks include infection, a tear in the membrane that covers the spinal cord, a blood clot in a leg vein and neurological deterioration.
- Questions and answers about spinal stenosis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Spinal_Stenosis/default.asp. Accessed April 19, 2012.
- Goldman L, et al. Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/191371208-2/0/1492/0.html#. Accessed April 19, 2012.
- Frontera WR, et al. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-6/0/1678/0.html. Accessed April 19, 2012.
- Cervical stenosis and myelopathy. North American Spine Society. http://www.knowyourback.org/Pages/SpinalConditions/DegenerativeConditions/CStenosis_Myelopathy_Radiculopathy.aspx. Accessed April 20, 2012.
- Levin K. Lumbar spinal stenosis: Treatment and prognosis. http://www.uptodate.com/index. Accessed April 20, 2012.
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