Spinal Stenosis Therapies Guide: How to Treat Narrowing of Spinal Canal?

If you’ve recently been diagnosed with spinal stenosis, you may be wondering how to treat the narrowing of the spinal canal. This common spinal condition can trigger significant pain, stiffness, and neurological symptoms, making it difficult to get through your daily activities. 

Thankfully, patients today have access to numerous treatments for spinal stenosis, including innovative therapies that reduce the risk of complications. This article will provide a comprehensive spinal stenosis therapy guide to help you better understand the solutions at your disposal.  

Table of Contents

You’ve Got a Spinal Stenosis Diagnosis. What’s Next?

After receiving a spinal stenosis diagnosis, your physician will discuss a treatment plan to address your symptoms. Aside from this prescribed treatment plan, it’s important to adjust your routine to prevent flare-ups and further damage to the spine. 

Adjustments to make after receiving a spinal stenosis diagnosis include:

  • Remain active with gentle, low-impact exercise. 

While following your physician’s instructions and restrictions, stay mobile with low-impact exercise. Extended periods of bed rest with spinal stenosis can exacerbate pain and stiffness while contributing to muscle atrophy. Try forms of exercise that don’t trigger symptom flare-ups, like walking, swimming, and gentle strengthening exercises. 

People diagnosed with spinal stenosis are generally recommended to exercise at least three times per week for 30 minutes. Your physician can help you determine the best routine for your situation. 

  • Adjust your routine to prevent pain flare-ups. 

After being diagnosed with spinal stenosis, consider the activities in your routine that may trigger pain. For example, if you work at a desk, you may start to experience pain after sitting down for several hours. Adjusting your routine by taking frequent breaks from sitting and purchasing a more supportive desk chair may help with your spinal stenosis symptoms. 

  • Quit smoking and using nicotine products. 

If you smoke or use nicotine products, a spinal stenosis diagnosis is your sign to quit. Nicotine constricts blood vessels throughout the body, hindering the flow of oxygen and nutrients to your spine. This can compromise the healing process and prolong your symptoms. 

  • Focus on your posture. 

With a busy schedule, it’s easy to let your posture fall by the wayside. However, poor posture can worsen spinal stenosis symptoms and even speed up the condition’s progression. So, after being diagnosed with spinal stenosis, practice proper spinal alignment throughout the day, whether you’re standing, sitting at your desk, or exercising. 

  • Eat healthily to manage inflammation. 

While adjusting your diet may not provide a dramatic improvement in your spinal stenosis symptoms, it can help in the long run by preventing systemic inflammation. Certain foods provide anti-inflammatory benefits, including:

  • Leafy greens, like spinach and kale
  • Olive oil
  • Tomatoes
  • Fatty fish, like tuna, salmon, and mackerel
  • Fruits, like cherries, blueberries, strawberries, and oranges
  • Nuts, like walnuts and almonds

Other foods can contribute to inflammation in the body and may compromise your recovery process. These foods include:

  • Red and processed meat
  • Processed baked goods
  • White bread and pasta
  • Deep fat fried foods
  • Foods and drinks containing added sugar
  • Trans fats

How to Treat Spinal Stenosis Without Surgery?

It’s possible to treat spinal stenosis without surgery through physical therapy, medications, lifestyle changes, steroid injections, chiropractic care, acupuncture, and PRP injections. 

Most cases of spinal stenosis are treated successfully without surgery. However, to prevent the need for surgical intervention, it’s important to seek medical care soon after you start having symptoms. Early intervention helps slow the disease’s progression and preserve the spinal tissues. 

To treat spinal stenosis without surgery, it’s often helpful to combine multiple therapies in a single treatment plan. For example, a patient may adopt lifestyle changes, attend physical therapy appointments, and take anti-inflammatory medications to manage spinal stenosis. 

Spinal Stenosis Treatments

Spinal stenosis treatments are available to suit many patients’ needs. Patients with mild to moderate spinal stenosis can consider non-surgical therapies, like medications, physical therapy, and more. Patients with severe spinal stenosis may need to consider surgical treatments for complete symptom relief. 

Spinal Stenosis Medications

Some medications are prescribed for spinal stenosis. While these medications may reduce your symptoms, they can’t cure the condition and may cause side effects. Physicians generally don’t prescribe these medications for long-term use. 

Medications that are most often prescribed for spinal stenosis include:

  • Non-steroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are common medications that reduce inflammation and pain. Examples include ibuprofen, naproxen, and aspirin. Many NSAIDs are available over the counter, although your physician may prescribe a higher dose if appropriate. 

  • Corticosteroids

Corticosteroids are another type of anti-inflammatory medication that works by decreasing immune system activity. This medication can be taken orally in the form of a pill, or it can be injected directly into the spine. In either case, corticosteroids can’t be taken for a prolonged period, as they suppress the immune system. 

  • Muscle relaxants

Muscle relaxants may be prescribed for spinal stenosis to alleviate numbness, tingling, muscle spasms, and radiating pain. Different muscle relaxers provide different effects, so your physician can help determine the best option for your symptoms and medical history. Examples of prescription muscle relaxants for spinal stenosis include cyclobenzaprine, baclofen, and methocarbamol. 

  • Neuroleptics

Neuroleptics are also known as antipsychotic medications. They block dopamine receptors in the brain and calm overactive neurons in the spinal cord. This can help lessen pain, tingling, and numbness in the extremities caused by spinal stenosis. 

Before prescribing medications for spinal stenosis, your physician will consider potential interactions with other medications you’re taking and the risk of complications. In some cases, the risks of prescription medications outweigh the benefits. 

Acupuncture for Spinal Stenosis

Acupuncture is often referred to as an alternative or complementary treatment. It’s not a primary medical treatment for spinal stenosis, but can be used to complement conventional therapies, like medication. Some people prefer alternative therapies like acupuncture due to the low risk of side effects and complications. 

During an acupuncture session, a trained acupuncturist inserts small, sterile needles into specific points on the body (known as acupuncture points). This is thought to stimulate the body’s healing response, boost circulation throughout the body, and alleviate tension. Acupuncture has been found to significantly alleviate symptoms of degenerative lumbar spinal stenosis in clinical studies

PRP Injections for Spinal Stenosis

PRP stands for platelet-rich plasma, a substance derived from human blood that’s rich in natural growth factors. It’s used in regenerative medicine to stimulate healing and tissue regeneration. 

While PRP therapy is still a relatively new treatment for spinal stenosis, it may be an alternative to surgery for some patients. PRP injections have been widely used to treat musculoskeletal conditions, including spinal disorders, with success. It’s thought to work by stimulating tissue repair and regeneration in the spine, leading to relief from spinal stenosis symptoms.  

What Spinal Stenosis Surgery Brings

Spinal stenosis surgery brings spinal decompression with a form of stabilization. 

Surgical Spinal Decompression

The most common spinal decompression procedure used for spinal stenosis is laminectomy. During this procedure, the surgeon takes out at least a portion of the lamina (the piece of bone that covers the back of the spinal canal). This creates more space in the spinal canal around the nerve roots, allowing them to heal. 

Other spinal decompression procedures include:

  • Discectomy, during which part some or all of a damaged spinal disc is removed
  • Foraminotomy, during which the foramina (openings in the vertebrae that allow nerves to extend out from the spinal canal) are surgically enlarged

Stabilization

Removing tissue in spinal decompression surgery can destabilize the spine. To prevent injuries and degeneration from destabilization, spinal decompression is conventionally followed by spinal fusion.

Spinal fusion involves positioning bone graft material between two or more vertebrae. This fuses the vertebrae into a single bone, preventing all motion and instability. It can take up to a year for the vertebrae to fully fuse. 

Although fusion keeps the spine stable after spinal stenosis surgery, it has several downsides, including:

  • Reduced spinal mobility, which may limit your activities
  • The risk of increased degeneration in the surrounding spinal segments
  • The risk of failed spinal fusion
  • Extended hospital stay (up to four days)
  • Long recovery period (up to a year)

Considering these risks, spinal fusion alternatives are attractive to both physicians and patients today. One alternative is a non-fusion implant, like the TOPS System, which stabilizes the spine after decompression surgery without eliminating motion at the affected segment. We’ll discuss the TOPS System as a spinal stenosis treatment innovative in a later section. 

Post-Surgery Recovery

Post-surgery recovery for spinal stenosis procedures with fusion generally involves four to six weeks of rest before returning to work. The recovery period for non-fusion procedures is much shorter. 

Physical therapy can help you regain strength and mobility after spinal stenosis surgery. Although rest is important, patients must remain mobile after surgery to prevent muscle atrophy, lost mobility, and increased pain.  

Physical Therapy and Exercises

Physical therapy involves targeted exercises, stretches, and passive treatments (i.e. massage and heat/cold therapy) to:

  • Reduce the formation of scar tissue, which can increase stiffness and pain
  • Manage inflammation and pain
  • Strengthen the muscles that support the spine (primary the abdominal muscles)
  • Improving the spine’s range of motion
  • Correct poor movement patterns that could compromise the recovery process

Your PT will provide exercises for you to complete at home throughout the recovery process. Examples of these exercises include:

  • Abdominal contractions
  • Wall squats
  • Heel slides (bending and straightening the knees while lying down)
  • Leg raises
  • Hamstring stretch

Innovative Treatments and Emerging Therapies for Spinal Stenosis

Innovative treatments and emerging therapies for spinal stenosis reduce risks, prevent complications, shorten recovery times, and improve results. 

Today’s leading spinal stenosis innovations include:

Regenerative Therapies 

We briefly discussed PRP injections as a regenerative therapy in a previous section. However, PRP injections are just one option for people considering regenerative therapies for spinal stenosis. Stem cell therapy is another emerging treatment that may help combat the effects of age-related spinal degeneration. 

Stem cells can regenerate into cells with specialized functions, making them critical to the body’s ability to repair damaged tissue. Unfortunately, the number and function of stem cells in the human body diminish with age. This decline contributes to age-related degeneration. 

In stem cell therapy, stem cells from bone marrow, fat tissue, or peripheral blood are extracted, isolated, and injected into the injured area (i.e. the spine). The stem cells are then thought to encourage tissue regeneration.  

Regenerative therapies for spinal stenosis aren’t yet widely available and may not be covered by your insurance plan. However, if you’re interested in PRP or stem cell therapy, research regenerative medicine clinics in your area for more information. 

Lumbar Interspinous Distraction Decompression

Lumbar interspinous distraction decompression is a surgical procedure to reduce pressure on impinged nerves from spinal stenosis. During the procedure, a spacer is inserted between the spinous processes on the ends of the vertebrae. The surgeon doesn’t need to open the spinal canal to place the spacer, which reduces risks and complications. 

The five-year success rate of lumbar interspinous distraction decompression has been reported at 68%, compared to a 56% success rate for bony decompression. 

The TOPS System

The TOPS System is a mechanical implant device for lumbar spinal stenosis and spondylolisthesis. It’s been approved by the FDA for degenerative spondylolisthesis with moderate to severe lumbar spinal stenosis. TOPS also earned a superiority-to-fusion claim from the FDA.   

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What makes TOPS superior to fusion? It’s designed to preserve motion in the lumbar spine after spinal decompression surgery. TOPS moves with the spine in all directions, allowing patients to safely return to various physical activities. 

After the TOPS procedure, patients immediately regain complete spinal mobility. This allows for a much faster return to their normal activities – and a much shorter hospital stay. Most people can walk around the hospital on the same day as the surgery.

If you’ve been diagnosed with lumbar spinal stenosis and are interested in the unique benefits of the TOPS System, find a doctor in your area today.