Three Options to Avoid Surgery With Spinal Stenosis

spinal stenosis

Hundreds of thousands of back surgeries are performed every year in the US. However, if you struggle with Spinal Stenosis, you may find relief and avoid surgery.

Spinal stenosis usually occurs after the age of 50. It is a narrowing of areas in the lumbar (back) or cervical (neck) spine, which causes pressure on the spinal cord or one of more of the spinal nerves. This can cause the pain you may be experiencing.

Spinal stenosis may be caused by:

* Arthritis involving the spine, usually in middle-aged or elderly people

* Herniated slipped disc

* Injury that causes pressure on the nerve roots or the spinal cord itself

* Defect in the spine that was present at birth (congenital defect)

* Tumors in the spine

The narrowing of the spinal canal can result in a number of symptoms. However, patients begin to experience problems when inflammation of the nerves occurs at levels of increased pressure.

Often, symptoms will gradually worsen over time. The symptoms can include:

* Numbness, tingling, cramping, or pain in the back, buttocks, thighs, or calves, or in the neck, shoulders, or arms

* Weakness of a portion of a leg or arm

Symptoms are more likely to be present or get worse when you stand or walk upright. They will often lessen or disappear when you sit down or lean forward. Most people with spinal stenosis cannot walk for a long periods of time.

More serious symptoms include:

* Difficulty or imbalance when walking

* Problems controlling urine or bowel movements

The diagnosis begins with a thorough medical history, and physical examination, with diagnostic testing including, x-rays, MRI and / or CT Scans to identify the source of pain.

Spinal stenosis responds well to non-surgical treatment.

Pain can be relieved with various medications depending upon your symptoms. Often narcotics are not prescribed to treat the pain from spinal stenosis.

An individualized physical therapy program can be very helpful. Physical therapy can help patients to learn how to take care of their back and how to manage recurrent episodes of back pain, thereby reducing the need for medications in most cases. In physical therapy, the muscles of the abdomen, back and legs are strengthened which helps in reduce the symptoms of nerve compression. Education on proper posture and body mechanics are an essential part of this process, thereby helping to avoid surgery.

When pain is not relieved by medications or physical therapy, an epidural steroid injection (ESI) can be performed under fluoroscopy for symptomatic relief. Fluoroscopic or x-ray guidance is the current standard of care with epidural steroid injections. Multiple studies have shown that improper placement can occur up to 34% of the time outside the epidural space when fluoroscopy is not utilized.

An epidural can help to further reduce pain and inflammation by reducing compression on the nerves. Usually you will notice a difference within 48 to 72 hours.

If the pain is persistent and does not respond to non-surgical measures, surgery may be necessary as an attempt to improve your quality of life. This is an elective procedure.

However, if spinal stenosis is causing a worsening neurologic deficit such as a foot drop, surgery may be indicated and not elective. In rare cases, some patients experience problems controlling urine or bowel movements due to stenosis. If you find yourself in this position, you should undergo a surgical evaluation.

With severe cases of stenosis, surgery can be performed. The goal of the surgery is to relieve pressure on the spinal cord or spinal nerve by widening the spinal canal or the foraminal canal. This is done by removing, trimming, or realigning the abnormal anatomy that is causing the compression of the nerves.

Surgery in spinal stenosis can be avoided and the pain can be eliminated!

Medications, physical therapy and epidural injections are viable non-surgical options for treating spinal stenosis.

Ask your doctor if you are a candidate for a non-surgical treatment to relieve your pain from spinal stenosis.

穢2011Winifred D Bragg, MD. All Rights Reserved.