Neurosurgeon Questions Spinal Stenosis

Treatment options for spinal stenosis?

My friend has spinal stenosis, and it's affecting his quality of life. What are the treatment options for spinal stenosis?

5 Answers

Physical therapy, spinal injections, spinal decompression, and fusion surgeries can be offered.
I'm not sure how to answer this without talking to him, examining him, and looking at his MRI. There are a lot of things to address here. First, spinal stenosis only needs to be treated if the cauda equina is compressed and you have claudication symptoms. Otherwise, spinal stenosis is irrelevant and does not need to be treated. If your friend has neurologic deficits from nerve compression in the spine, then the treatment for that is to decompress the nerves. I routinely decompress the cauda equina for patients with neurogenic claudication through a 2 cm incision as an outpatient. I did it twice yesterday. Everybody goes home the day of surgery with no stitches to remove and no bandage, and most are back to work in less than a week. If he has any instability where the stenosis is causing movement exacerbated back pain, then he may or may not need a fusion at the same time, which would increase his recovery time, but that is a different topic.
Usually flexion oriented exercises. You have to be cautious though due to the intricacies of the spine - easy to do the wrong thing. PTs treat it all the time. If the condition is debilitating, consider an orthopedic consult.
Oh poor chap. This condition can be quite debilitating and frightening. Pain is the worst symptom ,but with proper physiotherapy pain medications and keeping as active as possible is the key to managing this condition. New research is happening every day with new techniques in treatment. I would have him seen by a physciatrist to get on a pain medication schedule. This may be epidural with lidocaine for pain relief. Of course other medications. May also be used. In today’s medical world there is a lot that is being done to control,pain .its the pain that prevents patients moving forward. So getting a full examination by a physciatrist to ascertain level of mobility. Then on a program to maintain physical movement. Physiotherapy is helpful ,but have a proper head to toe examination and into a pain management program. Sometimes surgery is recommended, but this is a last resort and it does not always make things better. There really to date is no known cure. just management, pain being number one. Some patients find meditating helps and just more recently stem cell therapy. I hope this helps please feel free to get back in touch. Good luck
Physical therapy oral anti inflammatory medicine and x-ray guided epidural steroid injections were the usual conservative treatment options. Surgery only comes into play when it’s very severe and there is associated unrelenting pain or weakness in the legs.