What Drugs Can Be Given for Spinal Stenosis?

Spinal stenosis refers to chronic pain in the buttocks and a lack of feeling in the lower extremities. The condition is caused by the narrowing of the spinal cord, which leads to pinched nerves. Patients also describe a decreased ability to perform physical activity, and some patients begin to limp when they walk. The condition primarily affects those over the age of 60, and it is estimated that as many as 400,000 Americans may be affected.

Symptoms

• Symptoms of spinal stenosis include a persistent ache that ranges from dull to severe in the buttocks or lower back. The pain may be present when walking or doing other activities. Other symptoms include radiating pain in the legs and thighs, numbness in the lower extremities, weakness or the inability to move the lower extremities and decreased endurance. The pain typically lessens when you sit, bend forward or lie down, but pain relievers do not tend to alleviate the pain.

Diagnosis

• A doctor typically begins by taking your medical and familial history to rule out other genetic problems that may be the cause of the pain. This is generally followed by a physical examination in which the doctor evaluate the extent of impact on your ability to move, the amount of pain experienced by the patient and the extent of the loss of extremity reflexes. An MRI, a CAT scan, a myelogram or a bone scan may be necessary for a conclusive diagnosis.

Treatment

• There are two options for the treatment of spinal stenosis: surgical and nonsurgical. Nonsurgical treatment involves physical therapy, rest and the use of support devices when walking or engaging in activity. When nonsurgical treatment is recommended, typically drugs are also prescribed to add in the treatment. If nonsurgical options fail, surgery may be required.

Drug Treatments

• Nonsurgical treatments may involve the prescription of several different types of drugs including non-steroidal anti-inflammatory drugs, (NSAIDS) analgesics, or epidural steroid injections. Typically, these medications are prescribed along with a regimen of physical therapy, restricted exercises and support devices.

  Non-steroidal anti-inflammatory drugs are prescribed because it is believed that inflammation caused by the spinal stenosis is a major cause of the pain the patient experiences. Prescribed NSAIDs include ibuprofen, acetaminophen, naproxen and aspirin, and studies have demonstrated that no single one of these drugs has better results than the other.

  Analgesics are pain medications designed to relieve the symptoms associated with the spinal stenosis. Generally, nonprescription pain relievers are sufficient.

  Epidural steroid injections have also been used to help with pain caused by spinal stenosis, however few studies have been done to determine the effectiveness of these steroid injections.

Surgical Treatments

• Surgery may be required if physical therapy, combined with medications and support devices, does not reduce pain or restore movement. Generally, surgery is recommended only when other treatments fail and when the patient experiences lowered quality of life as a result of the spinal stenosis. There are several different surgical options for the treatment of spinal stenosis, including laminotomy, laminectomy, foraminotomy and spinal fusion.