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Spinal Stenosis - Treatment

The range of treatment options, and the risks and benefits of each should be discussed with your doctor. This will take into account any other health problems that might have an effect on the risks and benefits.

Mobility is generally good for the spine. Leaning forward often relieves some of the symptoms. Pushing a supermarket trolley may be easier than just standing. An exercise bike may help maintain fitness and reduce the risk of weight gain. Some patients find an all-terrain rollator frame useful for mobility and independence.

Non-Surgical treatment

Medications

The three main groups that are helpful for pain, either alone or in combination are
  • Non-Steroidal Anti- Inflammatory Drugs (N.S.A.I.D)
  • Neuropathic pain medications
  • Simple analgesics
Some medications have a high risk of harm and are not recommended, these would include strong opiate painkillers and diazepam type medications.

Exercise treatment

There are no specific exercise treatments for spinal stenosis. However, it is important to keep yourself fit and to keep as active as possible. Whatever exercise you enjoy and doesn’t cause too much discomfort is good for you. Cycling (e.g. on an exercise bike) can be very useful because the flexed position on the bike can give some relief of leg symptoms and is often an exercise tolerated well in spinal stenosis.

Injections

These can be helpful for pain that is going down the leg. They do not seem to be helpful for back pain.

Surgical Treatment

Surgical treatment should be discussed as part of shared decision making with your Doctor. It is usually a ‘quality of life’ decision and would only rarely need emergency treatment.

The most common operation is a simple decompression. This surgery will involve removing some bone to widen the spinal canal to relieve the pressure on the spinal cord or nerves. If required, a fusion may be done as part of the operation to decompress the nerves. This may involve a bone graft and metal screws and rods to stabilise the spine. Large studies on the outcomes of surgery for spinal stenosis have shown that early results such as quality of life, satisfaction with symptoms and self-rated progress were improvements that lasted over a long time after surgery.

The results of surgery are good with many patients experiencing useful improvements in walking distance and leg pain. There are some risks with spinal surgery. Patients are advised to discuss all treatment options with their Doctor.
EUROSPINE is a society of spine specialists of various disciplines with a large knowledge of spine pathologies. All well-known and accepted treatment modalities for spine pathologies are represented by the members of the society. However, the Society cannot accept any responsibility for the use of the information provided; the user and their health care professionals must retain responsibility for their health care management.
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