Question

Back Pain

Are there alternative treatments for spinal stenosis?

A Answers (2)

  • ACharles Simpson, DC, Chiropractic Medicine, answered

    There are a number of non-surgical treatments for lumbar spinal stenosis.  Most experts recommend trying other treatments first before surgery.  Physical therapy, exercises, chiropractic adjustments, acupuncture, massage and others may be helpful and make surgery unnecessary.

    The largest study of treatment for lumbar spinal stenosis has just been published in 2010 in the medical journal Spine (SPINE Volume 35, Number 14, pp 1329–1338).

    This study compared surgery to non-operative care that included so-called "usual care" consisting of exercises and medication.  Patients in this study got at least somewhat better regardless of whether they had surgery or not. 

    The surgical patients had a bit more more relief, but both groups improved.  About 1/2 of the non-surgical patients improved enough that they didn't need to have surgery.  Up to 13% of surgical patients had to have yet another operation to relieve their pain.

    This study did not examine "alternative" treatments such as chiropractic adjustments, acupuncture or yoga.  Most medical guidelines consider the  scientific evidence for the effectiveness of these alternative treatments to be inconclusive.  However most of these guidelines also note that these treatments are safe and not likely to make the stenosis worse when performed by a competent clinician.

    So considering that surgical versus non-surgical care produces similar results, it is reasonable to consider trying ,non-surgical treatments for spinal stenosis first.  Consulting with a good chiropractic physician or an acupuncture practitioner is a good choice for a second opinion prior to surgery.
    Helpful? 3 people found this helpful.
  • ARonald Tolchin, DO, Physical Medicine/rehabilitation, answered on behalf of Baptist Health South Florida
    The most common first step in treating spinal stenosis - that doesn't involve surgery or prescription medication - is physical therapy. A therapy program helps strengthen and stretch the muscles of the back, improving symptoms of nerve compression. 

    Spinal stenosis refers to the narrowing of the spinal column that causes pressure on the spinal cord, or narrowing of the openings (called neural foramina) where spinal nerves leave the spinal column. This condition often occurs over time in older adults, or the result of a disk herniation which occurred in the past, or can be the result of a congenital narrowing. The pain associated with spinal stenosis is most frequently in the legs and is manifested as leg heaviness, possible numbness and tingling, and limited ability to walk due to fatigue in the legs.

    Physical therapy includes massage, strengthening exercises, heat applications, traction and counseling that can help the patient continue therapy routines at home.

    Acupuncture, basic massage techniques and assisted Pilates are other alternative treatments for the pain of spinal stenosis. While weight loss can be difficult for those with the condition, even a loss of 10 pounds can relieve excess pressure on the vertebra. Gentle exercises, such as those associated with yoga, can increase flexibility.

    However, if exercise is not helping the pain or leg discomfort, you should see your physician to talk about other alternatives such as interventional pain management or possibly surgery depending on the severity of the stenosis.
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