Spinal Stenosis: Treatment

Treatment
Treatment has improved immensely since the 1950s when the pharmaceutical options were largely limited to aspirin and cortisone. In the absence of severe or progressive nerve involvement, a doctor may prescribe one or more of the following conservative treatments:

Non-steroidal anti-inflammatory drugs, such as aspirin, naproxen (Naprosyn), ibuprofen (Motrin, Nuprin, Advil), to reduce inflammation and relieve pain. New generation Cox-2 inhibitors have shown remarkable results in many cases.
• Analgesics, such as acetaminophen (Tylenol), to relieve pain.

• Corticosteroid injections into the outermost of the membranes covering the spinal cord and nerve roots to reduce inflammation and treat acute pain that radiates to the hips or down a leg.

  >Restricted activity (varies depending on extent of nerve involvement).

• Physical therapy and/or prescribed exercises to maintain motion of the spine and build endurance, which help stabilize the spine.

• A lumbar brace or corset to provide some support and help the patient regain mobility. This approach is sometimes used with patients with weak abdominal muscles or older patients with degeneration at several levels of the spine.

Surgery
Like all surgeons, I view surgery as the last resort following a complete exploration of other treatment options. You may be surprised to know that fewer than 5% of patients consulting a spine specialist ever actually have surgery.

The most common surgical solution to spinal stenosis is a laminectomy. The term is derived from two words: lamina (part of the spinal canal's bony roof) and -ectomy (removal).

The object of a laminectomy is to remove the pressure on the nerve root. The pressure is the cause of the pain and other debilitating effects of stenosis. The operation can be performed using traditional or microsurgical techniques. The decision is largely governed by your surgeon's preference. The surgeon removes bone and debris from the foramen to reduce pressure on the nerve root.

Recovery
Healing is the body's natural process of restoring its damaged tissues to a normal or nearly normal state. Although healing may be improved by general good health, proper nutrition, rest and physical fitness, healing is a natural process.

Recovery is the process during which you work to become well. It requires a gradual but persistent effort to increase physical strengths and minimize weaknesses. You must concentrate on what is improving, rather than on what symptoms remain. This focus on progress that has been made, combined with the constant effort to improve, make up the positive attitude that will speed your return to normal daily activity, over the next 3 months.