Nonsurgical Treatment of Spinal Stenosis

Spinal stenosis can frequently be treated with medications. Unless your symptoms are very serious, your physician will probably choose to start out your treatment this way.

The first step is to relieve pain and inflammation where the nerves are compressed. Analgesics include pain relievers such as acetaminophen (Tylenol®) can control pain, but do not have any effect on inflammation. Non-steroidal anti-inflammatory drugs (NSAIDS) include aspirin, ibuprofen (Advil™ or Motrin®), indomethacin and naproxen, among others. These products relieve pain and also reduce inflammation and swelling. They are called non-steroidal because they are not corticosteroid drugs, another class of anti-inflammatory medications.

Other nonsurgical treatments for spinal stenosis include physical therapy and wearing a brace or corset to support the back. A physical therapist can show you exercises to help you build up and maintain strength, endurance, and flexibility for spinal stability. Some of these exercises will help strengthen your abdominal muscles, since they help support the back. Physical therapy can also include the use of heat or ice packs, ultrasound, electrical stimulation, and massage. These treatments can relax tight muscles and ease pain or discomfort. A back brace or corset can also help support your back and may be especially helpful for people who have degeneration in more than one area of the spine.

In more severe cases of stenosis, your doctor may inject a corticosteroid medication into the spinal fluid around your spinal cord and nerve roots. This may be referred to as an epidural injection. Corticosteroids can be especially helpful in treating pain that radiates down the back of your leg. Many people report almost immediate relief from the injections. But corticosteroids have several serious side effects. Because of these side effects, most doctors limit the number of injections a patient should have.

Your doctor may also suggest that you rest your back by restricting your activities. Rest followed by a gradual return to exercise can help the back heal in some cases.