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Treatments and drugs
By Mayo Clinic staff
Medications
If over-the-counter pain relievers aren't enough to control your pain, your doctor may prescribe:
- Antidepressants. Nightly doses of tricyclic antidepressants, such as amitriptyline and nortriptyline, may help ease pain caused by spinal stenosis.
- Anti-seizure drugs. Some anti-seizure drugs, such as gabapentin (Neurontin) and pregabalin (Lyrica), are used to reduce pain caused by damaged nerves.
- Opioids. Drugs such as oxycodone (Percocet) and hydrocodone (Vicodin) contain substances related to codeine, which 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
- Control your pain
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 vertebrae 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 Dec. 21, 2009.
- Curlee PM. Spinal stenosis. In: Canale ST, et al. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa.: Mosby Elsevier; 2007. http://www.mdconsult.com/das/book/body/176085454-4/931784364/1584/313.html#4-u1.0-B978-0-323-03329-9..50044-1--cesec14_2092. Accessed Dec. 21, 2009.
- Meleger AL. Cervical stenosis. In: Frontera WR, et al. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/177277239-7/935792099/1678/9.html#4-u1.0-B978-1-4160-4007-1..50008-0--cesec8_89. Accessed Jan. 5, 2010.
- Bartleson JD (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 31, 2010.
- Isaac Z, et al. Lumbar spinal stenosis. In: Frontera WR, et al. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/177277239-4/935690969/1678/49.html#4-u1.0-B978-1-4160-4007-1..50048-1_751. Accessed Jan. 5, 2010.
- Spinal stenosis. American College of Rheumatology. http://www.rheumatology.org/public/factsheets/diseases_and_conditions/stenosis.asp. Accessed Dec. 22, 2009.
- Cauda equina syndrome. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00362. Accessed Jan. 5, 2010.
- Levin K. Lumbar spinal stenosis: Treatment and prognosis. http://www.uptodate.com/home/index.html. Accessed March 3, 2010.
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