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. Some NSAIDs, such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve), are available without prescription.
  • Muscle relaxants. Medications such as cyclobenzaprine (Amrix, Flexeril) can calm the muscle spasms that sometimes 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) and pregabalin (Lyrica), are used to reduce pain caused by damaged nerves.
  • Opioids. Drugs such as oxycodone (Oxycontin, Percocet, others) and hydrocodone (Lortab, Vicodin, others) contain substances related to codeine and can be habit-forming.

Therapy

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, repeated steroid injections can weaken nearby bones and connective tissue, so only a few injections a year are allowed.

Surgery

Surgery may be considered if:

  • More conservative treatments haven't helped
  • You're disabled by your symptoms
  • You're in good health otherwise

The goal is to relieve the pressure on your spinal cord or nerve roots. For example, a laminectomy removes the back part (lamina) of the affected vertebra to create more room within the spinal canal. In some cases, vertebrae also may need to be fused together to maintain the spine's strength.

In most cases, surgery helps 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.