Drugs, Medications, and Spinal Injections for Spinal Stenosis

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Depending on the severity of your lumbar (low back) or cervical (neck) spinal stenosis, your doctor may recommend an over-the-counter (OTC) medication to help relieve inflammation and pain. However, if an OTC drug does not provide good pain management, a prescription medication may be provided.
Tylenol sitting on shelves at the store.Pain relievers such as acetaminophen (Tylenol) can control pain, but don't have any effect on inflammation.Quick OTC facts:

  • Pain relievers such as acetaminophen (Tylenol) can control pain, but don't have any effect on inflammation.
  • If you want to fight both your pain and inflammation, you may consider non-steroidal anti-inflammatory drugs (NSAIDs). These products relieve pain and also reduce inflammation and swelling. NSAIDs include aspirin, ibuprofen (Advil or Motrin), and naproxen (Aleve).

Prescription Medications May Help Relieve Your Neck or Back Pain
If you've taken over-the-counter medications but are still experiencing spinal stenosis-related pain, your doctor may recommend prescription medications to combat your pain. Prescription-strength NSAIDs are a common prescription medication used to control spinal stenosis pain.

Spinal Injections are a Pain Management Option for Treatment of Spinal Stenosis
Moderate to severe pain and symptoms related to spinal stenosis may be managed by a pain management specialist who is trained in spinal injection therapies under fluoroscopy (real time x-ray). He/she may inject a corticosteroid (steroid) medication into the space(s) around specific nerve roots.

An epidural steroid injection delivers the corticosteroid medication into the epidural space, where the targeted nerve root(s) is located. A corticosteroid is a strong anti-inflammatory drug that help to relieve swelling of soft tissues that may be impinging on one or more nerve roots. Furthermore, by reducing inflammation at the source, pain and symptoms felt in the body's extremities (eg, leg, arm) may be reduced too. The epidural injection may provide total and permanent relief—or it may reduce your pain for several weeks to several months.

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 can have significant side effects. These are rare, but you should know and discuss the risks with your doctor.

Potential side effects of an epidural corticosteroid spinal injection include:

  • Increased pain at the injection site(s)
  • Anxiety
  • Weight gain
  • Difficulty sleeping
  • High blood sugar (more so for people with diabetes)
  • High blood pressureDecreased ability to fight infection (more so for people who already have an infection)
  • Stomach ulcer
  • Damage to the bones in your large joints, like your hips (such as avascular necrosis)
  • Cataracts

After an epidural injection, call your doctor immediately if you:

  • Have trouble controlling your bladder and/or bowels
  • Fever after you get the injection (if it's above 101º for more than 24 hours, you should let your doctor know)
  • Lose feeling and/or function in your arms or legs
  • Experience a terribly painful headache when you sit up or stand, and the only way to make it feel better is to lay down
  • Have extreme pain that doesn't go away when you try typical pain-fighting measures (eg, over-the-counter medications)

Because of these potential serious side effects, most doctors limit the number of injections a patient receives. The actual number of injections a patient receives is determined by many factors. Be sure to talk through this issue with your doctor.

Updated on: 02/22/18
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Exercises for Spinal Stenosis
Jason M. Highsmith, MD
This article was reviewed by Jason M. Highsmith, MD.
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Exercises for Spinal Stenosis

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