Treatments and drugs

By Mayo Clinic Staff

The type of treatment you receive for spinal stenosis may vary, depending on the location of the stenosis and the severity of your signs and symptoms.

Medications

To control pain associated with spinal stenosis, your doctor may prescribe:

  • NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) help relieve pain and reduce inflammation common to osteoarthritis. Some NSAIDs, such as ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve), are available without prescription.
  • Muscle relaxants. Medications such as cyclobenzaprine (Amrix, Flexeril) can calm the muscle spasms that occasionally occur with spinal stenosis.
  • Antidepressants. Nightly doses of tricyclic antidepressants, such as amitriptyline, can help ease chronic pain.
  • Anti-seizure drugs. Some anti-seizure drugs, such as gabapentin (Neurontin, Gralise, Horizant) and pregabalin (Lyrica), are used to reduce pain caused by damaged nerves.
  • Opioids. Drugs that contain codeine-related drugs such as oxycodone (Percocet, OxyContin, others) and hydrocodone (Norco, Zohydro, others) can be habit-forming.

Therapy

It's common for people who have spinal stenosis to become less active, in an effort to reduce pain. However, that can lead to muscle weakness, which can result in more pain. A physical therapist can teach you exercises that may help:

  • Build up your strength and endurance
  • Maintain the flexibility and stability of your spine
  • Improve your balance

Steroid injections

Your nerve roots may become irritated and swollen at the spots where they are being pinched. Injecting a corticosteroid into the space around that constriction can help reduce the inflammation and relieve some of the pressure. However, steroid injections don't work for everyone. And repeated steroid injections can weaken nearby bones and connective tissue, so only a few injections a year are suggested.

Surgery

Surgery may be considered if more conservative treatments haven't helped or if you're disabled by your symptoms.

The goal is to relieve the pressure on your spinal cord or nerve roots by creating more space within the spinal canal. Examples include:

  • Laminectomy. The procedure removes the back part (lamina) of the affected vertebra. In some cases, that vertebra may need to be linked to adjoining vertebrae with metal hardware and a bone graft (spinal fusion) to maintain the spine's strength.
  • Laminotomy. This procedure removes only a portion of the lamina, typically carving a hole just big enough to relieve the pressure in a particular spot.
  • Laminoplasty. This procedure is performed only on the vertebrae in the neck. It opens up the space within the spinal canal by creating a hinge on the lamina. Metal hardware bridges the gap in the opened section of the spine.

In most cases, these space-creating operations help reduce spinal stenosis symptoms. But some people's symptoms stay the same or get worse after surgery. Surgical risks include infection, a tear in the membrane that covers the spinal cord, a blood clot in a leg vein and neurological deterioration.

Aug. 05, 2015