Spinal stenosis medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Conservative management, including medications, physical therapy, and lifestyle changes, is encouraged for the treatment of spinal stenosis. If cervical spinal stenosis is mild, treatment may be as simple as physical therapy and the use of a cervical collar. If severe, treatment options include laminectomy, hemilaminectomy, or decompression. Treatment for lumbar spinal stenosis includes weight loss, and activity modification, such as using a walker to promote a certain posture. Epidural steroid injections may also help relieve the leg pain. If the symptoms are more severe, a laminectomy or foraminotomy may be indicated to take pressure off the spinal nerve. Various other medications may help with chronic pain, including phenytoin, carbamazepine, or tricyclic antidepressants such as amitriptyline.
Medical Therapy
Epidural Corticosteroid Injections
Epidural corticosteroid injections may offer benefit for one to two weeks. However, the benefit may be entirely due to the accompanying local anesthetic and the benefit is minimal to none by four to six weeks (see Forest plot to right).