The treatment for spinal stenosis depends on where in the back it is and how bad it is. Treatments include:
- Pain medicines: Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen:
- NSAIDs like ibuprofen (e.g., Advil and Motrin) help relieve pain and reduce inflammation.
- Acetaminophen (Tylenol) relieves pain.
- Opioid pain medicines like codeine or morphine.
- Muscle relaxants for muscle spasms that may happen once in awhile.
- Antidepressants to relieve pain.
- Nerve pain medications to relieve pain from damaged nerves.
- Physical therapy to strengthen the muscles that support the back, increase flexibility and stability, and improve balance.
- Injection of medicine into the spine:
- Steroid injections to reduce inflammation and treat pain that goes to the hips or down a leg.
- Nerve blocks, which put an anesthetic near the affected nerve to temporarily relieve pain.
- Braces to provide some support to the back and make it easier to move.
- Acupuncture to treat pain in less severe spinal stenosis.
- Chiropractic manipulation to relieve pain.
- Surgery. In severe spinal stenosis, doctors may recommend surgery to make more room for the spinal cord or nerves. Usually, doctors try other treatments first. Surgery might be the first treatment if you have numbness or weakness that interferes with walking or loss of bowel or bladder function.
Types of surgery for spinal stenosis are:
- Surgery to make more space for the nerves by removing the lamina, a thin part of the spine bones (or vertebrae). Sometimes, the surgeon “welds” or fuses the bones together so that they heal into a solid bone. To help the bone heal, the surgeon also uses:
- A bone graft (putting in a piece of bone from another part of the body or a bone bank) to help new bone grow.
- Plates, screws, and/or rods to help hold the spine still while it heals.
This is the most common surgery for spinal stenosis. Sometimes, surgeons can do it minimally invasively. (This surgery is called decompressive laminectomy).
- Surgery to remove a part of the lamina to relieve pressure in 1 spot. (This surgery is called laminotomy).
- Surgery to make space for the nerves in the neck by creating a hinge on the lamina. The surgeon covers the opened part of the spine with metal hardware. (This surgery is called laminoplasty).
Most of the time, surgery can relieve pain for a while but does not cure spinal stenosis.