Lumbar Stenosis Treatment Options
Lumbar spinal stenosis is narrowing of the spinal canal in the lower back that develops over time with age-related wear and tear arthritis. It is the most common reason for spine surgery in older adults. The main feature of lumbar spinal stenosis is pain that radiates from the back and hip into the legs during walking and standing. This limits the ability to walk and has a major impact on quality of life.
What is nonsurgical treatment?
Nonsurgical treatment is designed to improve pain and function and is usually recommended as a first treatment because it is successful in treating pain and improving function in mild to moderate lumbar spinal stenosis. It includes:
- Over-the-counter anti-inflammatory pain medications including Ibuprofen
- Analgesic medications that do not address inflammation including Acetaminophen
- Antidepressants to ease pain
- Antiseizure drugs (Gabapentin) can reduce pain
- Short-term opioids
- Yoga, massage and physical therapy. Physical therapy can help ease symptoms and improve flexibility, strength, balance and stamina.
- Activity modification
- Epidural steroid injections (ESIs) are a minimally invasive procedure that can help to relieve pain caused by spinal stenosis and disc herniation. Some people get great relief while others do not. ESIs can provide improvements is sciatic nerve pain and lumbar spinal stenosis. Recent research reports that epidural steroid injections are associated with immediate pain reduction and improved function, but effects do not last long. For patients with osteoporosis, caution is in order as steroid epidurals have been associated with bone loss.
When nonsurgical treatments fail to improve pain and function, your Dallas Neurosurgical & Spine expert will recommend consideration of minimally invasive procedures and surgical decompression. The treatment choice depends on the location and degree of stenosis; the severity of symptoms; past treatments; and other comorbid conditions.
What are the surgical options for lumbar spinal stenosis?
Surgery involves taking the pressure off the spinal cord or spinal nerves. This is called a decompression. It is accomplished by removing bone and soft tissues from around the spinal canal. Another common procedure is to fuse two or more lumbar vertebrae after decompression to provide stability, when the spine seems unstable. There are various techniques and approaches to accomplish the goals of relieving pain and restoring function. Recent studies confirm that decompression alone, decompression with fusion and newer devices are safe and effective at improving lumbar function and quality of life.
Dallas Neurosurgical & Spine has served Dallas and the surrounding areas since 1973. We are a renowned team of board-certified and fellowship trained neurosurgeons with the experience and mission to provide state-of-the-art care with compassion and commitment.