spinal stenosis

What Is the Newest Treatment for Spinal Stenosis?

Conventionally, cases of spinal stenosis that can’t be resolved with non-surgical therapies have been treated with laminectomy and spinal fusion. Laminectomy creates more space in the spinal canal, while spinal fusion stabilizes the spine. 

Regrettably, spinal fusion is a major surgery that comes with many significant risks and downsides. Along with a sizable percentage of patients who require reoperation, fusion diminishes patients’ spinal flexibility, which can limit their mobility. 

Considering these risks and drawbacks, many medical professionals have been seeking out fusion alternatives that can effectively treat spinal stenosis patients. Now, we have a greater range of treatment options available, the newest of which allows patients to avoid fusion altogether. 

Here, we’ll discuss the newest treatment for spinal stenosis and how it may benefit the spinal stenosis recovery process.  

Table of Contents

• Can Spinal Stenosis Get Better Without Surgery?
• Spinal Stenosis Severity Gradation and Corresponding Treatment Options for Every Grade
• What Is the Effective Treatment for Severe Spinal Stenosis that Require Surgery?
• Why Consider The Newest Spinal Stenosis Treatment?

Spinal Stenosis Therapies

Spinal stenosis therapies include physical therapy, massage therapy, acupuncture, chiropractic care, epidural steroid injections, and medications. 

Physical Therapy

Physical therapy for spinal stenosis utilizes targeted movements, strengthening exercises, and stretches to alleviate pressure on the affected spinal nerves. These methods help improve the spine’s range of motion and strengthen specific muscle groups to minimize impact on the spine. Physical therapy is often used as the primary treatment in people with mild to moderate spinal stenosis. 

Many physical therapists offer additional tools to support spinal health, including manual therapy, specialized equipment, and education. This education may include tips to adjust your lifestyle to reduce pressure on the spinal nerves and facilitate healing. 

Massage Therapy

Massage therapy is commonly considered an alternative treatment for spinal stenosis. This means that it may be used instead of traditional or conventional therapies, like medications. However, your doctor may incorporate massage therapy into your treatment plan to enhance the benefits of medication and physical therapy. 

A trained masseuse can manipulate the body’s soft tissues to reduce muscle tension, improve range of motion, and promote relaxation. These benefits may enhance your spinal stenosis recovery. Research shows that massage may help with chronic lower back pain caused by certain spinal conditions, including spinal stenosis. 

Acupuncture

Acupuncture is a treatment rooted in ancient Chinese medicine that involves inserting tiny needles into specific points on the body. This is thought to reduce muscle tension and open up the body’s healing pathways. While research concerning the effectiveness of acupuncture for spinal stenosis varies, some studies show that it can help reduce lower back pain. 

Chiropractic Care

Chiropractic care centers around joint and soft tissue manipulation to support musculoskeletal and nervous system health. Chiropractors use a range of methods to improve spinal alignment, boost mobility, and increase circulation throughout the body. They also often provide lifestyle recommendations to support the body’s natural healing process. 

Adjustments from your chiropractor may help reduce nerve compression from spinal stenosis. Studies show that it can help reduce spinal stenosis pain, although further research is required to confirm its benefits. 

Epidural Steroid Injections

Epidural steroid injections involve injecting steroid medication into the area surrounding the spinal cord, known as the epidural space. Steroid medication curbs inflammation, which may relieve spinal nerve compression pain. Research shows that steroid shots can also improve overall function in spinal stenosis patients. 

Receiving too many steroid injections in a short period can contribute to tissue atrophy. Your doctor can help you understand if steroid injections are right for you and how to prevent complications. 

Medications

Various over-the-counter and prescription medications are used to treat spinal stenosis, including NSAIDs, analgesics, muscle relaxants, anticonvulsants, and antidepressants. NSAIDs, analgesics, and muscle relaxants are the most widely prescribed medications for spinal stenosis. 

Medications can provide short-term relief from spinal stenosis pain, inflammation, and muscle spasms. While they can help with symptom management while you recover from spinal stenosis, they’re not a long-term solution. Ask your doctor about the possible side effects and complications before starting medications for lower back pain. 

Spinal Stenosis Treatment

Spinal stenosis treatment may include non-surgical therapies and, in severe cases, surgery. 

Non-surgical spinal stenosis, as mentioned above, may include:

• Physical therapy
• Massage therapy
• Acupuncture
• Chiropractic care
• Epidural steroid injections
• Medications

Additionally, as part of your spinal stenosis treatment plan, your physician may recommend lifestyle adjustments, including:

• Implementing a low-impact exercise routine to keep you active, mobile, and strong
• Reaching and maintaining a healthy weight for your height, as extra pounds place more stress on your spine
• Quitting smoking, as nicotine hinders your body’s natural healing process
• Improving your posture, especially if you sit at a desk for much of the workday, to keep your spine in proper alignment
• Taking breaks from prolonged periods of sitting, and investing in an office chair with lumbar support
• Adjusting your sleep position to prevent straining your spine (sleeping on your side or back is ideal)
• Managing your stress levels with methods like meditation, journaling, and breathing exercises, as stress can worsen back pain

Surgical spinal stenosis conventionally involves laminectomy with spinal fusion. Together, these procedures create more space in the spinal canal and restabilize the affected spinal segment. 

Laminectomy is a spinal decompression procedure that involves removing some or all of the lamina. The lamina is a piece of bone that covers and protects the back of the spinal cord. If you have spinal bone spurs that are contributing to your spinal stenosis, your surgeon will likely also remove them during laminectomy. 

Spinal fusion is commonly used to stabilize the spine after tissues are removed in decompression surgery. It permanently fuses two or more vertebrae together, eliminating all motion at the fused segment. 

Unfortunately, while spinal fusion prevents instability after surgery, it comes with various risks and drawbacks. Most significantly, it can notably compromise your spinal mobility and involves a lengthy recovery period. Later in this article, we’ll discuss available fusion alternatives for individuals with spinal stenosis. 

Can Spinal Stenosis Get Better Without Surgery?

First off, let’s consider non-surgical treatment options for spinal stenosis. Many patients with mild to moderate cases of spinal stenosis can improve their symptoms without going under the knife. This claim is supported by recent medical research. 

A 2022 paper published in the Journal of the American Medical Association evaluated patients with lumbar spinal stenosis and their condition after three years without operative intervention. About one-third of the patients’ conditions improved, about half of patients experienced no change in their symptoms, and 10% to 20% of patients’ symptoms worsened. 

With these results in mind, patients with moderate to severe cases of spinal stenosis often require surgery for lasting symptom improvement. 

Spinal Stenosis Severity Gradation and Corresponding Treatment Options for Every Grade

Physicians evaluate the severity of spinal stenosis using a grading system. There are three different grading systems that they may choose between the Lee system, the Schizas system, and the Miskin system. 

The Lee and Schizas systems are the most popular spinal stenosis grading systems. The Miskin system was more recently developed but has proven to reduce inconsistencies between neuroradiologists and musculoskeletal radiologists. 

Patients diagnosed with mild to moderate spinal stenosis based on one of the systems listed below can consider non-surgical treatment options. However, patients with moderate to severe and extreme stenosis will likely need to consider surgery to attain significant relief. 

The Lee Grading System

The Lee grading system is based on the amount of separation of the cauda equina using axial T2-weighted images. 

• Grade 0 or No Stenosis: No obliteration of the anterior CSF (cerebrospinal fluid) space
• Grade 1 or Mild Stenosis: Mild obliteration of the anterior CSF space, but the cauda equina are distinctly separated
• Grade 2 or Moderate Stenosis: Moderate obliteration of the anterior CSF space, and some cauda equina can’t be visibly separated
• Grade 3 or Severe Stenosis: Severe obliteration of the anterior CSF space, and no cauda equina can be visibly separated 

The Schizas Grading System

The Schizas grading system features seven grades based on the shape, size, and structure of the dural sac, as well as the proportion of rootlets to cerebrospinal fluid. Physicians use axial T2-weighted images to determine a grade using the Schizas system. 

• Grade A (No Stenosis or Minor Stenosis): Evident CSF in the dural sac, but the CSF distribution is uneven
  • Grade A1: The rootlets are positioned dorsally and take up less than half of the dural sac region.
  • Grade A2: The rootlets are positioned dorsally in a horseshoe shape and are touching the dura.
  • Grade A3: The rootlets are positioned dorsally and take up over half of the dural sac region. 
  • Grade A4: The rootlets are positioned in the center of the dural sac region and take up over half of this area. 

• Grade B (Moderate Stenosis): The rootlets take up the entire dural sac region but can be differentiated. The sac has a gritty appearance with some CSF. 
• Grade C (Severe Stenosis): No rootlets can be identified and no CSF is apparent. The sac has an even, gray appearance with posterior epidural fat. 
• Grade D (Extreme Stenosis): No rootlets can be identified and the posterior epidural fat has been destroyed.   

The Miskin Grading System

The Miskin grading system is an adapted version of the Schizas grading system. It was altered based on information from radiologists and non-radiologist spinal specialists. 

• Normal Spine: The nerve roots are openly spread out, not crowded, and the thecal sac’s anterior margin is flat or convex
• Mild Spinal Stenosis: The nerve roots are mildly crowded and the thecal sac’s anterior margin is flat or a little concave. The nerve roots can be differentiated from the CSF. 
• Moderate Spinal Stenosis: The nerve roots are crowded, giving the CSF a grainy appearance. The thecal sac’s anterior margin is concave. 
• Severe Spinal Stenosis: The nerve roots can’t be differentiated from the CSF. the thecal sac’s anterior margin is concave or indistinguishable.

What Is the Newest Treatment for Severe Lumbar Spinal Stenosis?

The newest lumbar spinal stenosis treatment has been referred to with many different names, including non-fusion implant and dynamic stabilization system, among others. These names all refer to devices that are used in place of spinal fusion to provide stability and symptom relief. Premia Spine TOPS System is the best one.

Non-fusion implants establish a controlled range of motion in the affected vertebrae. They replace the tissue removed during decompression surgery, ensuring that the spine remains stable after the procedure. 

In addition to spinal stenosis, many dynamic stabilization systems can effectively treat spondylolisthesis and degenerative disc disease. But, as the newest treatment option for spinal stenosis, dynamic stabilization systems aren’t yet being used throughout the U.S.

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One example, the TOPS System from Premia Spine, has received the breakthrough designation from the FDA, which allowed the start of an IDE investigation in 330 to 476 patients in the U.S. Patients with single-level spinal stenosis and spondylolisthesis may talk to their doctors about enrolling in this trial if they’re a good candidate for the TOPS System. In June 2023 it received FDA approval. The FDA granted TOPS approval for single-level spondylolisthesis between L3 and L5 with lumbar spinal stenosis. The system also earned a superiority-to-fusion claim for these spinal conditions, as it preserves motion in the lumbar spine.

Why Consider The Newest Spinal Stenosis Treatment?

Patients suffering from spinal stenosis symptoms have many factors to consider when choosing a treatment route. Although spinal fusion has been used since the early 1900s, it presents many notable downsides. Dynamic stabilization systems have a shorter history, but they were developed with the drawbacks of fusion in mind. Therefore, this route of treatment can help you avoid complications including:

• Adjacent segment disease
• Failed bone fusion (pseudoarthrosis)
• Lost spinal mobility
• Back muscle atrophy

Spinal stenosis patients should speak with an experienced spine specialist to find the right treatment option for their needs. 

What is The Best Painkiller For Spinal Stenosis?

If you’re suffering from spinal stenosis pain, you know that it can disrupt your daily activities. Unfortunately, severe spinal stenosis pain often limits patients’ mobility, making it difficult to perform basic tasks.  

Painkillers are commonly included in spinal stenosis treatment plans. In combination with physical therapy, lifestyle modifications, and other therapies, pain medications may help alleviate patients’ symptoms. 

In this article, we’ll discuss the best painkillers for spinal stenosis, as well as other treatment routes to consider. 

Table of Contents

• Why is My Spinal Stenosis So Painful?
• How Do You Prevent Spinal Stenosis From Getting Worse?
• What Helps Relieve Severe Spinal Stenosis Pain?
• What is The Best Muscle Relaxer for Spinal Stenosis?
• What is The Best Treatment for Spinal Stenosis at L4 and L5?
• Painkiller and Muscle Relaxant Combination

Why is My Spinal Stenosis So Painful?

Spinal stenosis is painful because as the spinal cord narrows, it puts pressure on the spinal cord and nerve roots. When these nerves become compressed, it causes pain, cramping, weakness, and/or tingling that can radiate from the back to the buttocks and down the legs. 

Additionally, spinal stenosis can become more painful with certain motions and activities. These includes:

• Long periods of walking
• Jumping
• Excessively bending and/or twisting the spine
• Contact sports, like football, basketball, and hockey
• Lifting with a rounded back

How Do You Prevent Spinal Stenosis From Getting Worse?

To prevent spinal stenosis from getting worse:

• Avoid motions and activities that strain the spine.
• Start a low-impact exercise routine to maintain mobility, flexibility, and muscle strength. 
• Work on improving your posture, as proper posture alleviates strain on the spinal tissues and structures. 
• Quit smoking and using nicotine products, as nicotine reduces blood flow to your spine.
• Maintain a healthy weight, as extra body weight puts extra stress on the spine. 
• Practice gentle stretches to prevent muscle tension, which can worsen spinal stenosis pain. 

What Helps Relieve Severe Spinal Stenosis Pain?

Medications, physical therapy, alternative treatment methods, and surgery can help relieve severe spinal stenosis pain.   

Physical Therapy

Physical therapy is one of the most effective non-surgical treatment options for spinal stenosis. PT helps alleviate pressure on the spinal nerves by promoting proper spinal alignment through targeted exercises, stretches, and alternative therapies like heat/cold therapy and electrical stimulation. 

The benefits of physical therapy for lumbar spinal stenosis include:

• Reduced pain and stiffness
• Relief from nerve compression
• Strengthened abdominal muscles
• Improved lumbar spine alignment

Lower Back Pain Medication

Lower back pain medication for severe spinal stenosis pain may include NSAIDs, antidepressants, anti-seizure medication, or corticosteroid shots. Medication can provide near-immediate relief from severe spinal stenosis pain, but may carry the risk of side effects and complications. 

• NSAIDs

NSAIDs, or nonsteroidal anti-inflammatory drugs, are common medications used to treat pain and inflammation. They’re available over the counter in the form of Advil, Aleve, and Motrin, as well as in prescription-strength varieties. 

• Antidepressants

Antidepressant medications may help with severe spinal stenosis pain by boosting levels of specific neurotransmitters in the spinal cord. These neurotransmitters lessen pain signals, leading to moderate pain relief. Unfortunately, antidepressants can take several weeks to provide significant relief from spinal stenosis pain. 

• Anti-seizure medication

Certain anti-seizure medications, including gabapentin and pregabalin, can help alleviate pain stemming from nerve damage. 

• Epidural steroid injections

Epidural steroid injections are commonly used for lower back pain caused by inflammation in the spinal nerves. The corticosteroid in the shot removes the proteins that cause swelling in the spinal nerves, leading to spinal stenosis pain relief.

However, physicians generally only allow patients to receive two to three injections per year. In excess, these injections can cause tissue damage. 

• Muscle relaxants

Muscle relaxants can improve muscle spasms, numbness, tingling, and radiating pain caused by spinal stenosis. 

What is The Best Muscle Relaxer for Spinal Stenosis?

The best muscle relaxer for spinal stenosis can vary from patient to patient. However, the best options include baclofen, cyclobenzaprine, and methocarbamol. 

• Baclofen

Baclofen is an antispastic drug that’s widely used to treat muscle spasms in spinal cord conditions, including lumbar spinal stenosis. It’s FDA-approved to treat symptoms of muscle spasticity caused by spinal conditions. By influencing the spinal nerves, baclofen has been found to alleviate pain, improve muscular motion, and loosen stiff muscles. 

The most common side effects of baclofen include drowsiness, weakness, dizziness, difficulty sleeping, nausea, more frequent urination, headaches, and constipation.

• Cyclobenzaprine

Cyclobenzaprine relieves muscle spasms from musculoskeletal conditions by working in the brain to reduce muscle hyperactivity. It may be used in patients with lumbar spinal stenosis to reduce pain and improve function. Unfortunately, cyclobenzaprine stops being effective after two to three weeks of use. 

The most common side effects of cyclobenzaprine include clumsiness, unsteadiness, fainting, confusion, dry mouth, constipation, drowsiness, nausea, and heartburn. 

• Methocarbamol

Methocarbamol blocks pain signals that enter the brain, providing relief from pain and muscle spasms. It has less of a sedating effect and lower rates of abuse when compared to other muscle relaxers.

The most common side effects of methocarbamol include drowsiness, dizziness, stomach upset, nausea, vomiting, lightheadedness, headaches, and blurred vision. 

Painkiller and Muscle Relaxant Combination

The combination of painkillers and muscle relaxants can be used for low back pain from spinal stenosis in some cases. The painkiller can help manage inflammation and discomfort, while the muscle relaxant can reduce muscle spasms and neurological symptoms. 

However, only certain types of pain medications can be safely combined with muscle relaxants. It’s important to speak with your physician before combining medications of any kind. 

Chlorzoxazone and Ibuprofen for Lumbar Spinal Stenosis

A 2019 study published in Pain and Therapy found that a fixed-dose combination of chlorzoxazone and ibuprofen was more effective than ibuprofen alone for acute low back pain. 

• Chlorzoxazone is a skeletal muscle relaxant, meaning that it’s prescribed to alleviate muscle spasms and pain caused by musculoskeletal conditions. It’s only available with a prescription from a physician – not over the counter. 
• Ibuprofen is an NSAID (nonsteroidal anti-inflammatory drug) and the active ingredient in Advil and Motril. Advil and Motrin are over-the-counter pain medications, but ibuprofen is also available at higher strengths (400, 600, and 800 mg) with a prescription. 

Carisoprodol and Aspirin for Lumbar Spinal Stenosis

Another common muscle relaxant and painkiller combination for musculoskeletal conditions is carisoprodol and aspirin. 

• Carisoprodol is a prescription skeletal muscle relaxant. It’s been approved for use in the U.S. since 1959. 
• Aspirin is an NSAID that’s commonly used to treat pain, fever, and inflammation. Similar to ibuprofen, it’s available over the counter and with a prescription in higher doses.  

Muscle Relaxant and NSAID Combination Pills 

Over-the-counter medications containing a muscle relaxant and NSAID in the same pill aren’t currently available in the United States. However, Robox Platinum is a combination pill available in Canada containing ibuprofen and methocarbamol, a muscle relaxant that alleviates pain and stiffness by assuaging overactive nerves. 

Cautions for Combining Muscle Relaxants and Painkillers

The combination of muscle relaxants and painkillers is being more widely used for back pain from conditions like spinal stenosis. However, despite its rising popularity, this combo can present certain health risks, including the risk of serious medical complications, in some cases. 

The greatest risk is associated with the combination of muscle relaxants with opioid painkillers. The U.S. Food and Drug Administration has noted that taking these medications together can lead to difficulty breathing and even death, among other adverse effects. 

Additionally, it’s important to note that muscle relaxants generally aren’t intended for long-term use. 

Over the Counter Muscle Relaxer

Over-the-counter muscle relaxants aren’t currently available in the United States. This class of medications is only available with a prescription. 

With that said, certain over-the-counter medications can offer muscle-relaxing benefits. For example, NSAIDs can help alleviate pain resulting from muscle tension. 

Many patients find that over-the-counter pain medications are sufficient for muscle tension and back pain. Your doctor will likely recommend that you start with OTC medications before considering prescription options to prevent side effects and complications. 

Keep in mind that NSAIDs shouldn’t be used long-term for muscle tension. High dosages and prolonged NSAID use can compromise muscle recovery. 

Over-the-counter medications that offer muscle-relaxing effects include:

Aspirin

Aspirin is a common over-the-counter NSAID. It may alleviate mild to moderate muscle aches and pain. Unlike other NSAIDs, like ibuprofen, aspirin has antiplatelet effects and can prevent blood clots. 

Ibuprofen

Ibuprofen (brand name Advil) is another popular over-the-counter NSAID. It alleviates pain, inflammation, and acute muscle aches. Compared to other NSAIDs, ibuprofen is one of the most effective options for muscle pain and sports injuries, as it offers anti-inflammatory benefits. 

Acetaminophen

Acetaminophen (brand name Tylenol) treats pain and fever. While it can help with pain from muscle tension, acetaminophen isn’t typically the NSAID of choice for muscular issues. Your doctor will likely recommend ibuprofen first, only reverting to other NSAIDs if ibuprofen doesn’t work for you. 

Naproxen

Naproxen (brand name Aleve) is another NSAID that, like ibuprofen, is a good choice for both inflammation and pain. It stands apart from other NSAIDs for its long-lasting effects; one dose of naproxen typically lasts for 12 hours. For reference, ibuprofen’s effects typically only last for six hours. 

While the NSAIDs listed above can help with muscle tension, talk to your doctor before using them for chronic back pain. Your doctor may determine that prescription muscle relaxants are a better choice for your needs. 

What is The Best Treatment for Spinal Stenosis at L4 and L5?

The best treatment for spinal stenosis at L4 and L5 that doesn’t improve with non-surgical methods is spinal decompression with the TOPS System. 

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Spinal decompression is widely performed for spinal stenosis. It involves alleviating pressure on the spinal nerves by removing structures or tissues. Laminectomy, a common form of spinal decompression for spinal stenosis, involves removing some or all of the lamina, which is the piece of bone that covers the back of the spinal canal. 

Spinal fusion has conventionally been performed after spinal decompression surgery to prevent instability. Fusion involves using bone graft material to permanently connect the affected vertebrae. Unfortunately, this process permanently limits patients’ mobility and creates the risk of adjacent segment degeneration. 

The TOPS System is an excellent alternative to spinal fusion for severe spinal stenosis at L4 and L5. It’s a mechanical implant device that replaces the tissues removed during the decompression procedure. It also creates a controlled range of motion, allowing patients to bend, flex, and twist without pain after the operation.

The TOPS System is approved by the FDA for individuals between age 35 and 80 with degenerative spondylolisthesis and moderate to severe lumbar spinal stenosis. The FDA also labeled the TOPS System as superior to spinal fusion for these conditions. 

If you’re suffering from spinal stenosis symptoms that don’t improve despite conservative therapies, find a specialist in your area to learn more about the latest treatment options. 

Spinal Stenosis: Self-Care Rules

If you’ve been diagnosed with spinal stenosis, self-care should be prioritized as part of your recovery. While it’s crucial to visit a physician for a treatment plan, much of the healing process will rely on your own recovery efforts. 

Self-care for spinal stenosis involves paying close attention to your symptoms, following your physician’s recommendations, and working to improve your health. Read on to learn more about our spinal stenosis self-care tips. 

Table of Contents

• How Do You Stop Stenosis From Progressing?
• How Can I Help Myself With Spinal Stenosis?
• Does Lying Down Help Spinal Stenosis?
• Is a Heating Pad Good for Spinal Stenosis?
• What is The Best Vitamin For Spinal Stenosis?

How Do You Stop Stenosis From Progressing?

To stop stenosis from progressing, it’s crucial to follow all of your physician’s recommendations and treatment suggestions. For most patients, these recommendations include:

• Maintaining good posture

Maintaining good posture is an excellent self-care strategy for spinal stenosis. Proper posture keeps the spine in alignment, which reduces the strain on the spinal structures. It can also help lessen nerve compression, which is a key issue for patients with spinal stenosis. 

• Avoiding high-impact activities

High-impact activities like running, weightlifting, and contact sports, as well as activities that involve excessive spinal extension, can worsen spinal stenosis. Avoiding these activities can help prevent further injury to the spine. 

• Practicing healthy body mechanics

Similar to good posture, proper body mechanics help minimize the impact on the spine with day-to-day motion. With healthy body mechanics, the spine is in a neutral position when you stand, walk, and exercise. 

• Staying active

Although it’s important to avoid high-impact physical activity with spinal stenosis, don’t write off exercise altogether. Staying active helps with the spinal stenosis healing process by promoting circulation, maintaining muscle strength, and preventing loss of mobility.  

• Attending physical therapy

Physical therapy is considered a crucial component of spinal stenosis treatment. Typically, physical therapists recommend a personalized set of exercises to strengthen the abdominal muscles, as well as stretches to improve mobility. Your PT may also recommend passive therapies, such as electrical stimulation, massage therapy, and acupuncture. 

• Taking breaks from sitting

If you work at a desk, you likely spend most of your day sitting down. Unfortunately, prolonged periods of sitting can be damaging to the spinal discs and back muscles. 

To care for your spine, try the “20-8-2” rule. This guideline recommends that people sit for 20 minutes, stand for eight minutes, and move around for two minutes. Then, repeat. 

While this rule will likely need to be adjusted to fit your needs, it’s a great place to start for spinal stenosis patients. 

• Prioritizing sleep

If you’re suffering from spinal stenosis or another spinal disorder, high-quality sleep is crucial. The deep stages of sleep increase circulation to the muscles, promote stress relief, and help reduce inflammation. 

Unfortunately, back pain from spinal stenosis can make it difficult to fall asleep at night. Many people find that the best sleep position for spinal stenosis is the fetal position. Additionally, investing in a top-caliber mattress, such as a latex or memory foam mattress, may help you fall asleep with spinal stenosis pain.  

How Can I Help Myself With Spinal Stenosis?

To help yourself with spinal stenosis, follow the tips provided above to stop the condition’s progression. These tips, including staying active, improving your posture, and preventing activities that stress the spine will help your body heal from spinal stenosis. Additionally, curbing the progression of this spinal condition may help you avoid invasive treatments in the future. 

Does Lying Down Help Spinal Stenosis?

Lying down may help reduce spinal stenosis symptoms in some patients. Most patients find that the best sleeping position for spinal stenosis is lying on the side of the body with the knees curled towards the chest in a fetal position. 

Though lying down can lessen spinal stenosis pain, it’s crucial to avoid staying in one position, whether it be lying down, sitting, or standing, for too long. Except for when you’re sleeping, of course, remaining in one position for an extended period can lead to muscle tension and increased pain. 

Is a Heating Pad Good for Spinal Stenosis?

A heating pad is good for spinal stenosis, especially if you’re experiencing muscle tension and tightness from the condition. Heat therapy promotes muscle relaxation and boosts circulation to the area. Circulation improves the flow of healing nutrients and oxygen to the injured spinal tissue, which promotes healing. 

Lumbar Stenosis Self-Care

Lumbar stenosis self-care involves protecting the lumbar spine from strain and supporting the body’s natural healing process. 

You may achieve this by:

Maintaining a Consistent Low-Impact Exercise Routine

Staying active with lumbar stenosis is important to avoid muscle weakness and lost range of motion. However, many physical activities place strain on the lumbar spine, including: 

• Golf, tennis, baseball, and basketball, which involve excessive lumbar twisting
• Weightlifting and football, which involve excessive pushing and pulling

While you should avoid the activities listed above, remain active with low-impact exercise to preserve muscular support for your lumbar spine. A consistent exercise routine will also support your body’s recovery process by promoting healthy circulation.  

Exercises that are generally considered safe for individuals with lumbar stenosis include:

• Walking
• Swimming
• Water aerobics
• Stationary biking
• Stretching and strengthening exercises provided by a physical therapist
• Yoga
• Tai Chi

Talk to your doctor before starting any new exercise routine to ensure it’s safe for you. 

Reaching a Healthy Weight

Excess pounds place undue stress on the lumbar spine throughout the day. Reaching a healthy weight with safe, proven weight loss methods can alleviate this stress and allow the spine to heal more effectively. 

Talk to your doctor to learn if weight loss may benefit your lumbar stenosis recovery plan. 

Eating a Nutritious Diet

Dietary factors can significantly influence your body’s ability to heal. More specifically, the foods you eat can contribute to inflammation; some foods have inflammatory effects, while others have anti-inflammatory effects. 

An anti-inflammatory diet can enhance your body’s recovery process and limit spinal inflammation. Anti-inflammatory foods include:

• Leafy greens, like spinach and kale
• Broccoli
• Peppers
• Avocados
• Berries
• Grapes
• Mushrooms
• Fatty fish, like salmon, tuna, and mackerel
• Olive oil

Inflammatory foods to avoid with lumbar stenosis include:

• Red meat
• Processed foods
• Fried foods
• Sugar
• Alcohol
• Refined carbohydrates

What is The Best Vitamin For Spinal Stenosis?

The best vitamins for spinal stenosis include vitamin B12, vitamin B9, vitamin C, vitamin D, magnesium, and omega-3 fatty acids. Vitamin supplementation can be used as part of your spinal stenosis self-care strategy, but check with your physician before starting any new supplement. 

• Vitamin B12

Vitamin B12 helps the body’s nervous system function properly. This makes it a valuable supplement for anyone suffering from neurological symptoms, including weakness, tingling, and numbness that can be caused by spinal stenosis. 

In a study published in the European Spine Journal, 72% of patients with spinal disorders reported improved symptoms after vitamin B12 supplementation. 

• Vitamin B9

Vitamin B9 (also known as folate or folic acid) is another B vitamin. As with all B vitamins, folate promotes a healthy nervous system and helps the body turn carbohydrates into glucose for energy.  

In a 2010 study funded by the NIH, researchers discovered that folate promoted healing in damaged spinal cord tissue in rats. These results indicate that folate supplementation may assist the healing process in patients with nerve-related injuries, such as nerve impingement caused by spinal stenosis. 

• Vitamin C

Vitamin C plays a few critical roles in healing and recovery. For one, the body needs vitamin C to produce specific neurotransmitters, as well as collagen and L-carnitine. It’s also a key part of connective tissue, which is essential for wound healing. 

Additionally, with powerful antioxidant properties, vitamin C can help fight free radical damage and cell death. This can be especially helpful for patients who are recovering from spinal stenosis surgery.

• Vitamin D

Osteoporosis is a key risk factor for spinal stenosis and other spinal injuries. Vitamin D can help ward off osteoporosis because it helps the body absorb calcium. 

Sun exposure is one of the best methods of vitamin D supplementation. But, people who don’t consistently spend time in the sun can consider supplements or foods that are rich in vitamin D, such as egg yolks and fatty fish. 

• Magnesium

Magnesium is an essential nutrient that plays several different roles in the body. It supports muscle function, nerve function, and energy production. Magnesium has also been found to provide neuroprotective benefits, suggesting that it may help prevent nerve damage in spinal stenosis patients. 

• Omega-3 Fatty Acids

A specific omega-3 fatty acid known as docosahexaenoic acid, or DHA, can be a helpful supplement for spinal stenosis patients. As the brain’s main fatty acid, DHT is crucial for central nervous system function and helps regulate cell membrane receptor activity. 

Additionally, a 2019 study found that omega-3 fatty acid supplementation may help protect against the progression of spinal disc degeneration. So, omega-3 fatty acid supplements may help patients with degenerative spinal stenosis avoid further damage to the spine.  

If at-home therapies fail to improve your spinal stenosis symptoms, visit a specialist in your area to learn about the available treatment options, such as the TOPS System from Premia Spine. 

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Severe Spinal Stenosis L4-L5 Symptoms

Spinal stenosis, a condition characterized by a narrowing spinal canal, often affects the lumbar spine. Lumbar spinal stenosis affects over 200,000 people in the U.S., making it a significant cause of pain and disability. The L4-L5 segment is often the site of spinal stenosis, as it supports the weight of the rest of the spine. 

Severe spinal stenosis L4-L5 can trigger a range of symptoms, including chronic lower back pain, tingling, numbness, and muscle weakness. In this article, we’ll dive deeper into these symptoms and available treatments to resolve them.

Table of Contents

• What Are the Symptoms of L4-L5 Nerve Damage?
• What Are the Symptoms of Severe L4-L5 Spinal Stenosis?
• Possible Complications of Severe L4-L5 Spinal Stenosis
• Is Spinal Stenosis L4-L5 Serious?
• Can Spinal Stenosis in L4 L5 Cause Paralysis?
• How Do You Treat L4-L5 Spinal Stenosis?
• Non-Surgical L4-L5 Spinal Stenosis Treatments

What Are the Symptoms of L4-L5 Nerve Damage?

The symptoms of L4-L5 nerve damage are:

• Lower back pain
• Pain that radiates into the lower extremities
• Tingling, numbness, and the feeling of “pins and needles” that radiate into the lower extremities
• Muscle spasms
• Increased sensitivity in the lower back

What Are the Symptoms of Severe L4-L5 Spinal Stenosis?

We go into more detail on this topic in our article: symptoms of severe L4-L5 spinal stenosis

• Severe lower back pain 
• Burning or radiating pain that moves from the lower back into the buttocks and legs
• Numbness and muscle weakness in the legs and feet
• Calf cramping
• Inability to walk without taking frequent breaks

Possible Complications of Severe L4-L5 Spinal Stenosis

Severe L4-L5 spinal stenosis can lead to serious complications if left untreated. These may include:

• Numbness and loss of sensation
• Decreased leg strength
• Loss of bowel or bladder control (incontinence)
• Difficulty with balance
• Higher risk of falls
• Sexual dysfunction

Without medical care, L4-L5 spinal stenosis can lead to permanent nerve damage and even paralysis. This makes it crucial to see a physician soon after the onset of spinal stenosis symptoms.  

How Does Spinal Stenosis Cause L4-L5 Nerve Damage?

With lumbar spinal stenosis, the spinal canal in the lower back becomes narrower. As space in the canal decreases, tissue (such as damaged disc material, thickened ligaments, or bone) may press on the spinal nerves. This can cause inflammation and damage over time. 

Is Spinal Stenosis L4-L5 Serious?

Spinal stenosis L4-L5 is serious because it can lead to chronic pain and lost mobility if left untreated.

In the early stages, spinal stenosis symptoms often don’t feel serious. Some patients experience only mild back pain. However, visiting a doctor for a diagnosis as soon as possible will slow the condition’s progression, reducing your risk of serious complications. 

As a condition that affects the spinal nerves, L4-L5 spinal stenosis must be treated promptly to prevent lasting damage. Patients need to take this condition seriously, not only to prevent nerve damage, but also to reduce the need for surgery. Most mild cases of lumbar spinal stenosis can be resolved without surgery with prompt care. 

Can Spinal Stenosis in L4 L5 Cause Paralysis?

Spinal stenosis in the L4 L5 segment can cause paralysis in severe cases. 

Paralysis can occur if the narrowing spinal canal presses on the spinal cord. The spinal cord is vital to the body’s ability to transmit motor commands between the brain and body. It also gives the body physical reflexes and relays sensory information to the brain.

Pressure from spinal stenosis can eventually damage the spinal cord. This may lead to full or partial leg paralysis, incontinence, and balance problems.

How Common is Paralysis from Lumbar Spinal Stenosis?

Paralysis from lumbar spinal stenosis is very rare. Treatment can prevent stenosis from progressing into this severe complication. 

How Do You Treat L4-L5 Spinal Stenosis?

You can treat L4-L5 spinal stenosis with conservative treatments including medications, steroid injections, physical therapy, and lifestyle changes. Severe L4-L5 stenosis often must be treated with surgery. 

Non-Surgical L4-L5 Spinal Stenosis Treatments

While non-surgical treatments can’t reverse the narrowing of the spinal canal, they can reduce inflammation, lessen the impact on spinal nerves, and reduce pain. 

The most common non-surgical treatments for L4-L5 spinal stenosis include:

• Anti-inflammatory medications can help with spinal stenosis pain and bring down swelling. Your physician may recommend over-the-counter medications (like acetaminophen) or, in more severe cases, provide prescription-strength drugs. Keep in mind that:
  • Medications alone usually can’t resolve spinal stenosis. It may be combined with other methods, like physical therapy, to provide lasting relief. 
  • Medications can cause side effects and interact with other drugs. Talk to your doctor about all the medications you’re taking (including supplements) before starting treatment. 
• Steroid injections lessen inflammation in the spinal canal. They’re administered into the epidural space, which is the area surrounding the spinal nerves. Keep in mind that:
  • Undergoing more than three to four steroid injections per year can cause tissue atrophy. 

• Physical therapy for L4-L5 spinal stenosis may involve strengthening exercises, flexibility exercises, stabilization methods, massage, and joint mobilization. Some physical therapists also recommend heat/ice therapy and acupuncture. PT can:
  • Reduce stress on the spinal nerves by strengthening the muscles that support the spine
  • Alleviate muscle tension and improve the spine’s range of motion
  • Improve spinal alignment to prevent excessive impact on the L4-L5 segment
• Lifestyle changes for L4-L5 spinal stenosis may include:
  • Complete gentle physical activity to boost blood flow and maintain mobility, like swimming, walking, and aerobics
  • Lose excess weight to reduce the impact on the L4-L5 segment
  • Follow an anti-inflammatory diet including vegetables, fruits, whole grains, olive oil, and spices like turmeric
  • Improve your posture, especially while sitting and standing 

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Surgery for Severe L4-L5 Spinal Stenosis

Severe L4-L5 spinal stenosis often requires surgery. Surgery can resolve nerve compression and create more space in the spinal canal. 

Surgery for severe L4-L5 spinal stenosis usually involves laminectomy. In this procedure, the surgeon removes some or all of the lamina (the bone covering the back of the spinal canal). This alleviates pressure on the spinal nerves and the spinal cord. 

Spinal fusion usually follows laminectomy to stabilize the spine. However, with concerns including reduced range of motion and adjacent segment degeneration, alternatives are gaining popularity. 
One alternative, the TOPS System, has been deemed superior to fusion by the FDA for lumbar spinal stenosis and spondylolisthesis. This dynamic implant stabilizes the spine and re-establishes a controlled range of motion. Contact a specialist in your area to learn more

What Are The Final Stages of Spinal Stenosis?

Spinal stenosis is a condition that impacts the structures of the spine, often due to age-related spinal degeneration or genetic factors. In either case, with this condition, the patient’s spinal canal narrows, leading to less open space surrounding the spinal cord and nerves. 

Table of Contents

• What Are the Final Stages of Spinal Stenosis?
• What is Considered Severe Spinal Stenosis?
• What Happens When You Have Severe Spinal Stenosis?
• Can You Live With Severe Spinal Stenosis?
• Severe Spinal Stenosis Surgery

Typically, spinal stenosis progresses at a slow pace if it’s not treated properly. As the condition advances, the open space in the spinal canal continues to decrease. Eventually, spinal stenosis can lead to nerve impingement as the spinal canal presses on nearby nerves. 

Understanding how spinal stenosis progresses and what to expect in the final stages of this condition can be helpful for patients. Continue reading for more information about this prevalent topic. 

What Are the Final Stages of Spinal Stenosis?

In the late stages, spinal stenosis causes:

• loss of body functions: no bladder or bowel control;
• saddle region numbness;
• numbness in feet or legs;
• leg pain when walking;
• inability to stand or walk.

The final stages of spinal stenosis may be effectively treated with surgery.

What is Considered Severe Spinal Stenosis?

Spine specialists generally take an MRI scan to determine the severity of a spinal stenosis case. An MRI can give the physician a detailed image of the spinal structures, which makes it possible to view how far the condition has progressed. 

Once the physician has obtained the MRI scan, they may use the following spinal stenosis grading system: 

• Stage 0: No lumbar spinal stenosis, no obliteration of the anterior cerebrospinal fluid (CSF) space
• Stage 1: Mild lumbar stenosis with visible separation of the cauda equina
• Stage 2: Moderate lumbar stenosis with some aggregation of the cauda equina so that they can’t be visibly separated
• Stage 3: Severe lumbar stenosis with no separation of the cauda equina

The cauda equina is a clump of spinal nerves and nerve rootlets found at the lower end of the spinal cord. These nerve roots’ function is to supply sensation to the legs, as well as support bladder and bowel function. 

What Happens When You Have Severe Spinal Stenosis?

With severe spinal stenosis, the spinal canal has narrowed to a considerable degree. As a result, patients with the severe form of this condition may experience a significant loss of function, potentially including bladder and/or bowel function.  

Additionally, lumbar spinal stenosis may be considered severe if conservative treatment options have repeatedly failed to improve the patient’s symptoms. 

Cauda Equina Syndrome

Severe spinal stenosis can cause cauda equina syndrome. This syndrome occurs when the cauda equina nerves, which are located at the lower end of the spine, are compressed. 

Cauda equina syndrome can cause permanent nerve damage and disability if it’s not treated immediately. Patients with spinal stenosis who experience symptoms of this syndrome should seek out emergency medical care. 

Symptoms of cauda equina syndrome include: 

• Loss of bladder or bowel control

A new loss of bladder or bowel control is a key symptom of cauda equina syndrome to be aware of. If you experience this symptom, make sure to contact your doctor immediately. 

• Saddle anesthesia

Saddle anesthesia affects the saddle region, which includes the buttocks, groin, genitals, and upper inner thighs. With this symptom, patients experience weakness, tingling, and/or numbness in all or part of the saddle area. 

• Sciatic nerve pain on the right and left sides of the body

Cauda equina syndrome can cause a stabbing, sharp, and/or hot pain that radiates from the bottom of the spine down the backs of the legs. In some patients, this pain may also travel into the calves and feet. 

• Neurological symptoms in the lower extremities

Patients with cauda equina syndrome may experience weakness, tingling, or numbness in the feet or legs. These sensations may occur on one or both sides of the body and may inhibit the patient’s ability to stand or walk.

Neurological symptoms in the lower extremities are also a symptom of spinal stenosis itself. This can make it difficult to identify this symptom as a sign of cauda equina syndrome. However, if you experience new or worsening neurological symptoms, or if they’re accompanied by other symptoms listed here, contact your doctor immediately. 

Can You Live With Severe Spinal Stenosis?

Unfortunately, spinal stenosis isn’t a curable condition – it can only be corrected with surgery. However, most patients can live normally with the condition if it’s treated in its early stages. 

Once patients have reached the final stages of spinal stenosis, they’re likely to experience a notable degree of disability. This may hold them back from partaking in normal activities. Additionally, patients with severe spinal stenosis are likely to experience back pain and neurological symptoms with day-to-day motions, including standing and walking. 

Surgery for severe spinal stenosis is typically required to restore patients’ quality of life. 

Severe Spinal Stenosis Surgery

Surgery is a spinal stenosis treatment option that specialists may recommend in severe cases. Generally, physicians don’t recommend spinal stenosis surgery unless patients have undergone six to 12 months of non-surgical treatment without symptom improvement. 

As a treatment for severe spinal stenosis, surgery typically involves spinal decompression. While there are multiple methods of surgical spinal decompression, laminectomy is the most common approach for spinal stenosis. 

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Laminectomy and Spinal Fusion

Laminectomy involves surgically removing some or all of the lamina to create more space in the spinal canal. The lamina is a small piece of bone that covers the back of the spinal canal, acting like a roof. By removing a portion of the bone, spinal surgeons can alleviate nerve compression and resolve patients’ symptoms. 

Along with laminectomy, severe spinal stenosis surgery often involves spinal fusion. Fusion is performed to prevent spinal instability by fusing the affected vertebrae into one bone. This is achieved with bone graft material. 

Unfortunately, spinal fusion can greatly limit patients’ mobility. After fusion, you can’t bend, twist, or flex the spine at the fused spinal segment. 

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Now, with motion preservation surgery and non-fusion implants, patients can undergo severe spinal stenosis treatment without the need for fusion. These procedures preserve patients’ mobility while alleviating the symptoms of severe spinal stenosis. 

If severe spinal stenosis is diminishing your quality of life, talk to a spine specialist about the complete range of treatment options available today.  

Is Spinal Stenosis Hereditary?

With a family history of any medical condition, it’s natural to worry that you’ll eventually develop the condition. This goes for spinal conditions, including spinal stenosis, which affects an estimated 250,000 to 500,00 residents of the United States. 

But, is spinal stenosis hereditary? Can you inherit it from your parents? In this article, we’ll address these common questions to resolve concerns surrounding your risk of developing spinal stenosis. 

Table of Contents

• Does Everyone Get Spinal Stenosis With Age?
• How Does The Spine Change With Age?
• Who is Prone To Spinal Stenosis?
• Will I Have Spinal Stenosis If My Parents Have It?
• What is The Final Outcome of Spinal Stenosis?
• What is The Newest Treatment For Spinal Stenosis?

Does Everyone Get Spinal Stenosis With Age?

Almost everyone will get spinal stenosis with age. This is because it tends to develop as a result of the natural effects of aging on the spine. However, this doesn’t mean that everyone will require spinal surgery at some point. 

Spinal stenosis refers to the narrowing of the spinal canal. For many patients, this process leads to nerve compression, which triggers pain and neurological symptoms. However, if the narrowed spinal canal doesn’t cause nerve impingement, the patient may be asymptomatic. 

How Does The Spine Change With Age?

The spine undergoes a variety of changes during the aging process, including:

Cartilage Degeneration

For one, the cartilage that protects the facet joints wears down over time. When this occurs, the bones rub against one another, leading to pain and inflammation. 

As the cartilage degenerates with age, patients may develop bone spurs. Bone spurs are the body’s response to friction between bones, and they can take up space within the spinal canal, leading to spinal stenosis. 

Disc Degeneration

Another effect of aging on the spine is disc degeneration. A cushion-like disc is located between each vertebra of the spine. This disc absorbs impact to prevent damage to the spinal structures. 

Unfortunately, the aging process causes the intervertebral discs to wear down, becoming thinner and drier. Eventually, this may cause the disc to bulge, herniate, or rupture. A damaged intervertebral disc can extend into the spinal canal and cause spinal stenosis.  

Thickened Ligaments

Ligaments are coarse bands of tissue that connect bone to bone. The ligaments of the spine work with tendons and muscles to keep the spine stable. 

With age, the ligaments of the spine can become thicker, especially in patients with arthritis. Thickened spinal ligaments may bulge into the spinal canal and cause spinal stenosis. 

Who is Prone To Spinal Stenosis?

Various factors may make certain people more prone to spinal stenosis than others. These factors include:

• Age

As discussed in the previous section, the natural aging process often leads to spinal stenosis. So, people over the age of 50 are more prone to spinal stenosis than younger individuals. 

• Gender

Women are more prone to spinal stenosis than men. Though the exact reasons for this risk factor are uncertain, experts think it may be linked to pregnancy, structural pelvic differences, and female hormone levels. 

• Genetic factors

Some people are born with a narrower spinal canal than others. A naturally narrow spinal canal makes you more likely to develop spinal stenosis, especially when it’s combined with other risk factors. 

• Other spinal conditions

Patients with a preexisting spinal condition, such as scoliosis or a spinal injury, have a higher risk of developing spinal stenosis. Trauma to the spine triggers the body’s natural repair process, which involves inflammation. If the spinal injury isn’t properly treated, the swelling can become chronic and may compromise the space in the spinal canal, leading to stenosis. 

Will I Have Spinal Stenosis If My Parents Have It?

You won’t necessarily have spinal stenosis if your parents have it. The condition isn’t thought to be inheritable, though genetic factors can influence your risk of developing spinal stenosis. 

A 2015 study evaluated the influence of genetic factors compared to environmental factors for lumbar spinal stenosis. It concluded that lumbar spinal stenosis is highly genetic and disc degeneration is one way in which genetics can affect spinal stenosis. 

Inherited vs. Acquired Spinal Stenosis

Inherited spinal stenosis occurs when you’re born with a narrower-than-average spinal cord. Acquired spinal stenosis results from age-related spinal changes and spinal degeneration. 

Acquired spinal stenosis is more prevalent than inherited spinal stenosis and can be caused by factors like:

• A herniated disc, as the damaged disc can protrude into the spinal canal and press on nearby nerves
• Osteoarthritis, as the body may produce bone spurs in response to increased friction; bone spurs can take up space in the spinal canal
• Spondylolisthesis, as the vertebra that slips out of its usual position can reduce the space in the spinal canal
• Thickened ligaments in the spinal canal
• Acute spinal injuries, which may involve fractures and swelling that narrow the spinal canal

Only 9% of spinal stenosis cases are caused by congenital (genetic) factors, such as:

• Shortened pedicles: Vertebral pedicles are cylindrical pieces of bone that help cover the spinal cord and link the vertebral body to the rest of the vertebra. Some people are born with shortened pedicles, which reduces the size of the spinal canal. 
• Achondroplasia is a genetic bone growth disorder that causes a protein (called the fibroblast growth factor receptor) to function atypically, leading to less cartilage growth. This can compromise the spinal canal. 
• Osteopetrosis refers to a collection of genetic bone growth disorders. Though rare, these conditions can make bone tissue too dense with a high risk of fractures. People with this condition have a higher risk of spinal stenosis. 
• Spinal dysraphism refers to several genetic conditions that impact the spine, spinal cord, and spinal nerve roots. These conditions cause an abnormal bony growth on the spine or spinal cord and can trigger spinal stenosis. 

How Long Can I Live With Spinal Stenosis?

You can live with spinal stenosis for the rest of your life. This spinal condition isn’t life-threatening, although it may be disabling in its severe forms. 

With this in mind, if spinal stenosis is left untreated, it can lead to serious, potentially-permanent nerve injury. One form of nerve injury that may result from lumbar spinal stenosis is cauda equina syndrome, which occurs when all of the nerves in the lower spine become compressed. If cauda equina syndrome isn’t properly treated, it can lead to permanent paralysis in one or both legs and permanent loss of bowel or bladder control. 

Seek out immediate medical attention if you’ve been diagnosed with spinal stenosis and experience any of the following signs of cauda equina syndrome:

• Severe lower back pain
• Saddle anesthesia, which is loss of sensation in the buttocks, perineum, and inner thighs
• Loss of bladder or bowel control
• Loss of sensation in both legs
• Loss of motor function in both legs
• Lost or reduced reflexes

Does Spinal Stenosis Shorten Life Expectancy?

Spinal stenosis isn’t known to shorten life expectancy, especially when it’s treated promptly. 

When spinal stenosis is successfully managed in its early stages, it’s not known to shorten life expectancy. Additionally, one study found that elderly patients who underwent spinal stenosis surgery had a lower mortality rate than the corresponding portion of the general population. So, even if it requires surgery, spinal stenosis may not impact life expectancy. 

Many factors can affect your life expectancy, several of which are in your control. If you have spinal stenosis, consider these tips to protect your longevity:

• Follow a low-impact exercise routine. Physical activity is known to positively affect life expectancy. While you shouldn’t partake in high-impact exercise with spinal stenosis, stay active with workouts like walking, swimming, and aerobics. 
• Manage stress. Having a chronic condition like spinal stenosis triggers stress in many individuals. Unfortunately, stress can compromise your longevity. Meditating, prioritizing sleep, journaling, and maintaining strong relationships can help you keep stress levels low. 
• Limit alcohol intake and quit smoking. Alcohol consumption and smoking can both worsen spinal stenosis while shortening your life expectancy. Try to kick these habits to protect your long-term health. 
• Attend all recommended doctor appointments. Especially with an underlying medical condition like spinal stenosis, regular doctor’s appointments are essential. Visiting your primary care physician once annually will preserve your longevity by ensuring that medical concerns are identified and addressed as early as possible. 

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• Reach and maintain a healthy weight. Being overweight or obese puts excessive strain on the spine while increasing your risk of other health concerns, like high blood pressure and heart disease. Maintaining a healthy weight is one of the best ways to improve your life expectancy. 
• Eat a nutrient-rich diet. Consuming a balanced, nutrient-rich diet can help keep inflammation at bay and prevent nutrient deficiencies. 

What is The Final Outcome of Spinal Stenosis?

The final outcome of spinal stenosis depends on the severity of the condition, the treatment plan, and how soon the patient sought out treatment. 

The Outcome of Spinal Stenosis With Non-Surgical Treatment

For some patients, non-surgical therapies fully resolve spinal stenosis. This is often the case when spinal stenosis is addressed in its early stages. Treatments that may help patients recover from spinal stenosis without surgery include:

• Physical therapy
• Rest and lifestyle modifications
• Anti-inflammatory medication
• Chiropractic care
• Acupuncture 
• Massage therapy
• Epidural steroid injections

For patients who improve with non-invasive treatments, it’s crucial to keep up with spinal care recommendations, such as maintaining proper posture, investing in a supportive desk chair, staying active, and avoiding activities that strain the spine. 

The Outcome of Spinal Stenosis With Surgical Treatment

Patients who don’t recover after six to 12 months of non-surgical spinal stenosis treatment may need surgery for symptom relief. Thankfully, decompression surgery generally provides good outcomes for spinal stenosis patients, offering long-term relief from back pain and neurological symptoms. 

Decompression surgery for spinal stenosis involves alleviating nerve compression by creating more space in the spinal canal. This is most commonly achieved with a laminectomy. This form of decompression surgery involves removing a small portion of the lamina (the roof of the spinal canal) to open up the spinal canal. 

Oftentimes, surgeons perform spinal fusion with decompression surgery to avoid spinal instability. Fusion involves permanently merging the affected vertebrae with bone graft material. This eradicates all motion at the targeted segment. 

Unfortunately, spinal fusion can lead to mobility restrictions in spinal stenosis patients. This, combined with the risk of adjacent segment degeneration, can compromise the outcome of surgical spinal stenosis treatment. 

What is The Newest Treatment For Spinal Stenosis?

The newest treatment for spinal stenosis is minimally-invasive spine surgery with the TOPS System. This device has long been used abroad to restore mobility and resolve symptoms in spinal stenosis patients. But, it’s only beginning to gain prominence in the United States as a safe, effective alternative to spinal fusion surgery. 

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The TOPS System is a dynamic spinal implant that creates a controlled range of motion in the spine. It’s designed to treat lumbar spinal stenosis and spondylolisthesis. Unlike spinal fusion, the TOPS System allows patients to recover quickly after surgery and regain the ability to move the spine in all directions without the risk of instability. 

Contact a specialist in your area to learn more about spinal stenosis and the latest innovations available to treat it. 

Spinal Stenosis Medication

Spinal stenosis can cause significant discomfort, pain, and nerve symptoms. In many cases, these symptoms disrupt patients’ daily routines, making it difficult to carry out their normal activities.

As part of a well-rounded treatment plan, spinal stenosis medications may help alleviate pain, inflammation, and muscle spasms. But, there are many considerations for taking these medications, including side effects, possible long-term complications, and interactions with other drugs. 

In this article, we’ll provide a comprehensive overview of spinal stenosis medication, including the benefits, risks, and alternative treatment options. 

Table of Contents

• What Is Spinal Stenosis and How Is It Treated?
• What Is the First-Line Treatment for Spinal Stenosis?
• What Is the Best Medication for Spinal Stenosis?
• Can Steroids Help Spinal Stenosis?
• What Muscle Relaxer Is Used for Spinal Stenosis?
• What Is the Most Successful Treatment for Spinal Stenosis in L4-L5?

What Is Spinal Stenosis and How Is It Treated?

Spinal stenosis is a condition involving the narrowing of the spinal canal. It’s treated with physical therapy, medications, lifestyle changes, and, in severe cases, surgery.

The spinal canal is a cavity that extends down the length of the spine. It consists of the hollow openings in the middle of each vertebrae, and it encloses the spinal cord. In fact, the spinal canal’s primary function is to protect the spinal cord and nearby nerves from damage.

With spinal stenosis, the spinal canal becomes abnormally narrow, leaving less space around the spinal cord and nerve roots. As the condition progresses, the canal may start to impinge on the spinal nerves, leading to radiating neurological symptoms, as well as persistent back pain. 

Spinal Stenosis Treatments

The most common spinal stenosis treatments include physical therapy, medications, lifestyle changes, and surgery.

• Physical therapy can help with spinal stenosis by increasing core and back muscle strength. Both of these muscle groups stabilize the spine, helping to absorb impact that would otherwise affect the spine. Additionally, a PT can provide tension-relieving stretches and additional therapies (like massage, heat/cold therapy, and electromagnetic therapy) for further symptom relief. 
• Medications can help reduce pain, inflammation, and muscle spasms from spinal stenosis. Though not a permanent treatment for this condition, medications can provide temporary pain relief and may complement other therapies, like PT.
  • Epidural steroid injections involve injecting steroid medication directly into the area of the spine affected by spinal stenosis. They can alleviate inflammation and ease pressure on the spinal nerves, allowing them to heal. However, patients can only undergo a limited number of injections per year to prevent tissue atrophy. 
• Lifestyle changes can naturally ease spinal stenosis pain. Examples include adjusting your activities, adopting a low-impact exercise routine, eating healthily, quitting smoking, and maintaining good spinal alignment.
• Surgery is usually only suggested for spinal stenosis if the condition causes serious disability or doesn’t respond to several months of conservative treatments. Spinal stenosis surgery involves spinal decompression and stabilization.  

What Is the First-Line Treatment for Spinal Stenosis?

The first-line treatment for spinal stenosis is physical therapy with activity adjustments. 

Physicians recommend these treatments first, before prescribing medications or considering surgery, because they’re low-risk. With physical therapy and activity modifications, patients don’t have to worry about side effects or possible complications. However, if these therapies fail to provide results, physicians typically move on to prescription pain medications and epidural steroid injections. 

What Is the Best Medication for Spinal Stenosis?

The best medication for spinal stenosis varies depending on the patient. However, non-steroidal anti-inflammatory drugs (NSAIDs) are often effective for spinal stenosis symptoms. 

NSAIDs for Spinal Stenosis

NSAIDs work by blocking cyclooxygenase, an enzyme that the body needs to produce prostaglandins. Prostaglandins are a collection of lipids that work like hormones in the body. They’re produced at areas of tissue damage in the body and affect various bodily processes, including pain and inflammation. 

By blocking cyclooxygenase, NSAIDs reduce prostaglandin production, leading to temporary relief from inflammation and pain associated with spinal stenosis. Many different NSAIDs are available, both over the counter and with a prescription. Physicians usually advise patients to begin with over-the-counter NSAIDs for spinal stenosis before considering prescription-strength medications. 

Examples of over-the-counter NSAIDs for spinal stenosis include:

• Aspirin
• Ibuprofen (brand names Advil and Motrin)
• Naproxen (brand name Aleve)

Prescription-strength NSAIDs can be used when over-the-counter options don’t provide spinal stenosis symptom relief. These drugs may involve higher dosages of the medications listed above, as well as celecoxib (brand name Celebrex). Celecoxib is only available with a prescription, but has been found to cause fewer gastrointestinal side effects than other prescription-strength NSAIDs. 

NSAID Safety

When prescribed by a qualified, licensed physician and used as advised, NSAIDs can be safely used to manage spinal stenosis pain. However, this type of medication should only be taken for a limited period and at the lowest effective dose. 

Possible side effects of NSAIDs include:

• Bloating
• Gas
• Stomach pain
• Heartburn
• Nausea
• Vomiting
• Constipation
• Diarrhea 
• Dizziness or lightheadedness
• Trouble concentrating
• Mild headache 

Gastrointestinal side effects are the most common with NSAIDs. Taking these medications with a meal, milk, or even antacids may help lower your risk of experiencing these symptoms. However, if side effects persist, reach out to your physician for guidance. 

Other Medications for Spinal Stenosis

While NSAIDs are the most common medication used for spinal stenosis, there are other options available. These include:

• Analgesics (also known as painkillers) alleviate pain but don’t impact inflammation. Examples include acetaminophen (brand name Tylenol) and tramadol. 
• Muscle relaxants can be used to treat the muscle spasms that some patients experience with spinal stenosis. Examples include cyclobenzaprine, baclofen, and methocarbamol. 
• Corticosteroids curb inflammation in the spinal canal, leading to reduced nerve compression and pain. The medications that may be used in epidural steroid injections include triamcinolone, methylprednisolone, dexamethasone, and hydrocortisone. 
• Anticonvulsants can help alleviate neuropathic radicular pain and lower back pain from spinal stenosis. Examples include gabapentin and carbamazepine. 
• Antidepressants can be used, in some cases, to help treat spinal stenosis. This type of medication may work by boosting neurotransmitters in the spinal cord, leading to decreased pain signals. Antidepressants that may be used for spinal stenosis include amitriptyline, clomipramine, and nortriptyline. 

Can Steroids Help Spinal Stenosis?

Steroids can help spinal stenosis by reducing inflammation in the spinal canal, helping to decrease spinal nerve compression. 

While steroids may help with spinal stenosis pain management in some individuals, there are risks and drawbacks to consider.

For one, spinal stenosis is a degenerative condition – it’s not caused by inflammation. Inflammation results from pressure on the spinal nerves. So, while steroids can help temporarily reduce its symptoms, they don’t address the root of the condition.

Additionally, epidural steroid injections pose some serious risks, including nerve damage and paralysis. These severe complications are rare, but worth considering. Less severe side effects of steroid injections include:

• Steroid flushing, which includes face and chest flushing for several days after the injection
• Anxiety
• Disrupted sleep
• Water retention
• Menstrual changes

Also, patients shouldn’t receive more than 3 steroid injections annually to prevent tissue atrophy, with at least 6 weeks between injections. 

What Muscle Relaxer Is Used for Spinal Stenosis?

The muscle relaxers that are used for spinal stenosis include:

• Cyclobenzaprine (brand name Flexeril)
• Carisoprodol (brand name Soma)
• Baclofen (brand names Lioresal and Lyflex)
• Methocarbamol (brand name Robaxin)
• Tizanidine (brand name Zanaflex)

Muscle relaxants hinder nerve signals traveling between the brain and spinal cord, leading to relief from muscle spasms. These medications can also help reduce many of the neurological symptoms associated with spinal stenosis, including numbness, tingling, and stabbing, shooting, or radiating pain. 

What Is the Most Successful Treatment for Spinal Stenosis in L4-L5?

The most successful treatment for spinal stenosis in L4-L5 can vary depending on the patient. However, in cases that don’t respond to conservative treatment, minimally invasive spinal decompression with non-fusion stabilization is often the best option. 

Minimally invasive spinal decompression surgery involves removing a small amount of tissue to create more space in the spinal canal. Depending on the exact procedure, the surgeon may remove part of the lamina, intervertebral disc, or thickened ligament. This process also alleviates pressure on the affected spinal nerves. 

Minimally Invasive Spinal Decompression for L4-L5 Spinal Stenosis

Compared to conventional spinal decompression surgery, minimally invasive procedures are safer, involve less postoperative pain, and lessen recovery times. They involve a smaller incision and less disruption to the surrounding tissues. Minimally invasive spinal decompression may involve the use of an endoscopic camera, allowing the surgeon to view the spinal canal through a very small incision. 

After removing tissue from the spinal canal, the surgeon typically must stabilize the spine to prevent future injuries. In past eras, the only option of stabilization was spinal fusion, which permanently joins two or more vertebrae using a bone graft. Now, spinal stenosis patients can opt for non-fusion options, like the TOPS System. 

The TOPS System for L4-L5 Spinal Stenosis

The TOPS System is a non-fusion spinal implant that’s been approved by the FDA for moderate to severe lumbar spinal stenosis. It’s also earned a superiority-to-fusion claim from the FDA, as it stabilizes the spine while preserving motion in all directions. This prevents reduced mobility, shortens recovery times, and reduces the risk of degeneration to surrounding vertebrae. 

If you’re experiencing symptoms of spinal stenosis, schedule an appointment with a qualified physician to learn more about spinal stenosis medications, along with other available treatments. 

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?
• How to Treat Spinal Stenosis Without Surgery?
• Spinal Stenosis Treatments
• What Spinal Stenosis Surgery Brings
• Post-Surgery-Recovery
• Innovative Treatments and Emerging Therapies for Spinal Stenosis

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. 

What Are The Symptoms of Severe Spinal Stenosis of The L4-L5 Segment and How to Treat It?

The spine consists of 33 vertebrae stacked on top of each other. Depending on their location, the vertebrae provide different degrees of load-bearing and flexibility for the spine. 

The L4-L5 spinal segment consists of the two lowest vertebrae in the lumbar spine. It provides motion in many directions and supports the upper torso. 

L4 and L5 undergo heavy impact with day-to-day motions and are highly flexible. This makes them particularly susceptible to injury and chronic conditions, including spinal stenosis. 

In this article, we’ll explore severe spinal stenosis of the L4-L5 spinal segment and the symptoms that most commonly accompany this condition. 

Table of Contents

• A Brief Overview of Spinal Stenosis
• What Are The Most Common Spine Segments That Spinal Stenosis Damages?
• Severe Spinal Stenosis L4-L5 Symptoms
• What Are The Symptoms of L4-L5 Damage?
• What is Cauda Equina Syndrome?
• What is The Best Treatment for Spinal Stenosis at L4 and L5?
• What Does Surgery For L4-L5 Spinal Stenosis Involve?
• Is An L4-L5 Fusion Major Surgery?
• Modern Alternative to L4-L5 Stenosis Surgery Fusion

A Brief Overview of Spinal Stenosis

Spinal stenosis affects roughly 250,000 to 500,000 people in the United States, making it one of today’s most prevalent spinal conditions. It occurs when the open spaces in the spinal canal become narrower, potentially leading to spinal nerve impingement. Spinal stenosis may also cause spinal cord compression. 

What Are The Most Common Spine Segments That Spinal Stenosis Damages?

Spinal stenosis most commonly occurs in the lumbar spine, followed by the cervical spine. Although the thoracic spine may also be affected by spinal stenosis, it’s far less likely. 

The lumbar spine includes the L1, L2, L3, L4, and L5 vertebrae. When spinal stenosis affects this area, it’s known as lumbar spinal stenosis. 

Lumbar spinal stenosis is most often caused by age-related spinal degeneration. The natural aging process can cause several changes in the spine that trigger stenosis, including:

• Wear and tear on the facet joints of the spine (osteoarthritis)
• Bone spurs
• Intervertebral disc damage (bulging or herniated discs)
• Thickened spinal ligaments

Severe Spinal Stenosis L4-L5 Symptoms

Severe spinal stenosis L4-L4 symptoms may include:

• Debilitating pain in the lower back and leg
• Sexual dysfunction
• Constant pain, numbness, and/or tingling in the legs while standing
• Difficulty or inability to perform upright activities
• Bladder or bowel incontinence
• Severe weakness in both legs
• Numbness in the genital and inner thigh area
• Foot drop

Sexual Dysfunction with Lumbar Spinal Stenosis

Lumbar spinal stenosis can cause sexual dysfunction or pain during intercourse. According to a 2022 study published in Sexual Medicine Reviews, more than half of patients with spinal stenosis and degenerative spine disease experience pain with sexual activity. 

Spinal stenosis can cause sexual dysfunction if it causes the compression of the nerves responsible for sexual function. This typically only occurs in severe cases. 

If you experience reduced sexual function or pain during intercourse with lumbar spinal stenosis, schedule an evaluation with a physician immediately. Prompt care is essential to prevent permanent nerve damage. 

What is Foot Drop with Spinal Stenosis?

“Foot drop” is a symptom resulting from weakness in the anterior tibialis muscle. It’s most often caused by L4-L5 radiculopathy, which can be triggered by spinal stenosis. 

With foot drop, it’s difficult or impossible to point the ankle and toes upward. This causes the foot to slap onto the ground while walking, with the leg dragging in front of the foot. Foot drop can also throw off your balance. 

Foot drop can be debilitating and may keep you from staying active with lumbar spinal stenosis. Thankfully, not all cases of foot drop are permanent, and many can be resolved with prompt treatment. Physical therapy, bracing, splits, and nerve stimulation are common non-surgical therapies for this symptom of L4-L5 spinal stenosis. 

L4-L5 Nerve Root Compression Symptoms

Symptoms of L4-L5 nerve root compression include:

• Pins and needles sensation in the legs and feet
• Chronic lower back pain
• Numbness, tingling, and weakness that travel from the lower back to the legs and feet
• Achiness in the back
• Back stiffness
• Cramping in the calves after short periods of walking or at night

Spinal nerve roots are the beginning portion of the spinal nerve as it exits the spinal cord. They’re responsible for supplying various parts of the body with sensation and triggering motion. 

The L4-L5 nerve roots are the lowest nerve roots of the lumbar spine. The cauda equina is typically located between spinal levels L1 and L5. So, nerve root compression at the L4-L5 levels may affect the cauda equina and pose the risk of cauda equina syndrome. 

Calf Cramping with Lumbar Spinal Stenosis

Lumbar spinal stenosis can cause frequent calf cramping, usually while walking or at night. Even slight motions can cause cramping in individuals with severe spinal stenosis.

This cramping is thought to be caused by nerve root compression. In other words, when spinal stenosis compresses the spinal cord, it activates the nerves that supply the muscles, making them engage and cramp. Leg cramping with spinal stenosis may indicate nerve damage and requires prompt medical care. 

What Are The Symptoms of L4-L5 Damage?

Some patients experience no symptoms from lumbar spinal stenosis. However, if this condition causes nerve impingement, it can provoke symptoms of sciatica. 

Sciatica is a diagnosis used to characterize pain in the sciatic nerve. The sciatic nerve stretches from the lower back to the buttocks and down the back sides of the legs. The main symptoms of sciatica include:

• Sharp pain that begins in the lower back and moves down the leg
• Weakness in the leg with motion
• Numbness in the leg, foot, and/or toes
• Tingling and/or pins-and-needles sensation along the sciatic nerve

Damage in the L4-L5 spinal segment may also lead to cauda equina syndrome, in severe cases. 

What is Cauda Equina Syndrome?

The cauda equina is a collection of nerve roots located in the lumbar spine. It includes nerve roots spanning from L2 to Co1 in the coccygeal spine. Cauda equina syndrome develops if multiple nerve roots included in the cauda equina are irritated or damaged. 

Warning signs of cauda equina syndrome include:

• Bladder and/or bowel dysfunction
• Saddle anesthesia, which occurs when the patient loses sensation in the buttocks, perineum, and inner thighs
• Weakness or paralysis of a nerve root
• Sciatica
• Sexual dysfunction

Left untreated, cauda equina syndrome can cause permanent nerve damage. So, if you’ve been diagnosed with spinal stenosis and experience the symptoms listed above, seek out emergency medical attention.  

What is The Best Treatment for Spinal Stenosis at L4 and L5?

In most cases, physicians first recommend a conventional treatment plan for lumbar spinal stenosis at L4 and L5. With early intervention, many patients can recover from this spinal condition without having to undergo surgery. 

The most common conventional treatments for spinal stenosis at L4 and L5 include:

• Physical therapy, which may involve strengthening and flexibility exercises, stabilization, joint mobilization, heat or ice therapy, and massage
• Lifestyle and activity modifications, such as quitting smoking and starting a low-impact exercise routine
• Over-the-counter or prescription medications, such as NSAIDs, analgesics, anti-seizure drugs, and antidepressants
• Chiropractic care, which focuses on improving spinal alignment with manual adjustments
• Acupuncture, which may help stimulate the body’s natural healing process

With that said, conventional treatment options can’t correct the narrowing of the spinal canal. Surgery is required to gain more space in the spinal canal and may be required if:

• Conventional treatment options fail to provide relief after six to 12 months
• The patient is at risk of permanent neurological damage
• The patient’s symptoms are severely disabling

What Does Surgery For L4-L5 Spinal Stenosis Involve?

Surgery for spinal stenosis at the L4-L5 segment most commonly includes laminectomy. This procedure involves removing some or all of the lamina to create more open space in the spinal canal and alleviate nerve compression. 

The lamina is a small piece of bone that forms part of the vertebral arch. It covers the back of the spinal canal. By removing some or all of this bony spinal component, your spinal surgery can effectively resolve symptoms of spinal stenosis. 

Unfortunately, a laminectomy can pose the risk of spinal instability. To negate this risk, many surgeons have paired the procedure with spinal fusion. 

Is An L4-L5 Fusion Major Surgery?

L4-L5 spinal fusion involves positioning bone graft material in between the L4 and L5 vertebrae. This causes the vertebrae to permanently fuse over several months. After this procedure, patients have no motion at the fused segment. 

Simply put, yes: L4-L5 fusion is a major surgery that must be performed by a neurosurgeon or an orthopedic surgeon. It’s a complex procedure, during which the patient must be under anesthesia. Additionally, the recovery process for spinal fusion can span a full year. 

Modern Alternative to L4-L5 Stenosis Surgery Fusion – Premia Spine TOPS System

Considering the risks and downsides of spinal fusion, many patients with L4-L5 spinal stenosis seek out ways to avoid it. Some patients may successfully achieve this feat by committing to a conventional treatment plan, including all recommended lifestyle adjustments. 

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Unfortunately, not all patients will experience relief from conventional treatments, even after several months or even years. In these cases, patients may consider spinal fusion alternatives, specifically including non-fusion implants. Modern medical technology has allowed for advanced implants that stabilize the spine after lumbar decompression without compromising the motion of the spine – Premia Spine TOPS System.

Reach out to a reputable spine specialist in your area to learn more about the latest fusion alternatives for L4-L5 spinal stenosis. 

Lumbar Spinal Stenosis Symptoms

Lumbar spinal stenosis is a prevalent condition affecting the lower portion of the spine. It’s usually triggered by age-related spinal degeneration and can cause significant lower back pain. Left untreated, lumbar spinal stenosis can cause disability and a reduced quality of life. 

Unfortunately, lumbar spinal stenosis affects many adults at some point in their later years. But, with the proper treatment, you can overcome spinal stenosis symptoms and gain a new lease on life.

In this article, we’ll review the types, causes, and symptoms of lumbar spinal stenosis, along with the latest treatment options to fix it. 

Table of Contents

• What Are the Main Types of Spinal Stenosis?
• What Are Conditions That Could Cause Spinal Stenosis?
• What Are the Worsening Symptoms of Spinal Stenosis?
• Can L4 L5 Stenosis Cause Paralysis?
• How Do You Fix Lumbar Spinal Stenosis?

What Are the Main Types of Spinal Stenosis?

The main types of spinal stenosis are central canal stenosis, lateral recess stenosis, and foraminal stenosis. 

Central Canal Stenosis

Central canal spinal stenosis occurs in the central spinal canal. The central spinal canal protects the spinal cord, so central canal stenosis poses the risk of spinal cord compression. 

Typically, central canal spinal stenosis involves thickened ligaments and bone overgrowth (i.e. bone spurs) that constrict the spinal canal. It may affect the upper, middle, or lower portion of the spine, though lumbar central canal stenosis is the most common. 

Lateral Recess Stenosis

Lateral recess spinal stenosis involves the narrowing of the lateral recess, the area near the sides of the spinal canal. Also known as Lee’s entrance, the lateral recess is near the spinal nerve root and acts as a passway for nerves. 

With this form of spinal stenosis, Lee’s entrance becomes smaller and smaller, limiting the space for the nerves. As a result, the nerves may become compressed by bone tissue and impair pressure on intervertebral discs. 

Foraminal Stenosis

Foraminal stenosis occurs when the intervertebral foramen narrows. The foramen are bony passageways through which nerves enter and exit the spine. They facilitate the delivery of nerve signals from the brain to the rest of the body. 

With foraminal stenosis, bone tissue may compress spinal nerve roots, leading to back pain and neurological symptoms, like numbness, weakness, and tingling. 

What Are Conditions That Could Cause Spinal Stenosis?

Conditions that could cause spinal stenosis include:

• Degenerative spondylolisthesis
• Bone spurs from osteoarthritis
• Herniated disc
• Spinal fractures
• Spinal tumors or cysts

Spinal Stenosis from Degenerative Spondylolisthesis

Degenerative spondylolisthesis occurs when age-related changes to the spine cause a vertebra to slip out of its normal position. The affected vertebra falls onto the vertebra beneath it and may reduce the space in the spinal canal, causing spinal stenosis. The vertebra may also compress nearby nerves, leading to neurological symptoms. 

Spinal Stenosis from Bone Spurs

Bone spurs are a common complication of osteoarthritis, a degenerative condition involving the breakdown of cartilage in the joints. As cartilage deteriorates, it increases friction and inflammation within the joints. Your body may gradually produce extra bone tissue – bone spurs –  in response to this friction. 

As small lumps of bone tissue, bone spurs take up space in the spinal canal, potentially causing symptoms of spinal stenosis. 

Spinal Stenosis from a Herniated Disc

A herniated disc is an intervertebral disc that becomes damaged, usually due to age-related spinal degeneration. Over time, the discs that cushion the spine become thinner, drier, and weaker. As a result, cracks can form in the tough disc exterior, and the jelly-like interior may push through it. 

The herniated disc (also known as a bulging or ruptured disc) can protrude into the open space in the spinal canal, causing spinal stenosis. 

Spinal Stenosis from Fractures

Vertebral fractures can result from weakened bone tissue (due to osteoarthritis) or a sudden trauma to the spine (like a fall). The broken bone can limit the space in the spinal canal, causing spinal stenosis. 

Spinal Stenosis from Cysts or Tumors

Spinal cysts or tumors take up space in the spinal canal and may cause spinal stenosis symptoms. In these cases, the cyst or tumor can typically be surgically removed to alleviate symptoms, protect neurological function, and stabilize the spine. 

What Are the Worsening Symptoms of Spinal Stenosis?

The worsening symptoms of lumbar spinal stenosis include back pain and numbness, tingling, and or weakness that radiates into the extremities. 

Back Pain from Spinal Stenosis

Back pain from spinal stenosis occurs in the area of the back that’s affected by a narrowed spinal canal. This condition most often affects the lumbar spine, causing lower back pain. 

Lower back pain is a primary spinal stenosis symptom that tends to get worse over time. The pain may feel like a dull ache, tenderness, or burning in the back. Additionally, lower back pain from spinal stenosis can come and go, with flare-ups from certain activities and motions, like excessive back extension.

Neurological Symptoms from Spinal Stenosis

Neurological spinal stenosis symptoms can also worsen over time. These symptoms result from spinal nerve compression and tend to include tingling, weakness, and numbness. If the compressed nerve is located in the lumbar spine, these symptoms may radiate into the buttocks, legs, and feet. 

Professional medical treatment for spinal stenosis can help prevent worsening symptoms and preserve your mobility. The sooner you seek treatment for this spinal condition, the more successful the treatment will be. Early intervention also helps prevent the need for surgery to treat spinal stenosis. 

Can L4 L5 Stenosis Cause Paralysis?

L4 L5 stenosis can cause paralysis if left untreated for a prolonged period. 

Signs of nerve compression in the L4 L5 segment of the spine include weakness, tingling, and/or numbness that radiate into the lower extremities. With proper treatment, it’s possible to lessen the pressure on the spinal nerves and improve these symptoms. However, if the nerve compression is left untreated for an extended period and becomes severe, it can cause partial or full leg paralysis. 

If you experience any of the following warning signs with L4 L5 spinal stenosis, seek emergency medical care to prevent permanent nerve damage and paralysis:

• Loss of bladder or bowel control (incontinence)
• Difficulty walking and/or balancing
• Lost or reduced sensation in the buttocks, inner thighs, backs of legs, feet, or heels
• Sexual dysfunction

How Do You Fix Lumbar Spinal Stenosis?

You can fix lumbar spinal stenosis with surgical procedures to decompress the spinal nerves. 

Unfortunately, non-surgical treatments can’t open the spinal canal back up after it’s been affected by spinal stenosis. Only surgery can achieve this feat. However, non-invasive methods can help resolve spinal stenosis symptoms in many cases. 

Non-invasive treatments for spinal stenosis include:

• Physical therapy
• Chiropractic care
• Pain medications
• Lifestyle adjustments (such as exercising, quitting smoking, and eating a nutrient-dense diet)
• Acupuncture
• Massage therapy

Surgery to Fix Spinal Stenosis

Surgery for spinal stenosis typically involves spinal decompression. This type of procedure resolves the nerve compression to alleviate lower back pain and neurological symptoms. Examples of these procedures include laminectomy, foraminotomy, and discectomy. 

Spinal decompression can destabilize the spine. To offset this risk, decompression procedures are conventionally performed with spinal fusion, a process of fusing two or more vertebrae to prevent instability. 

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While fusion can prevent injuries due to instability, it also limits the patient’s mobility and may accelerate degeneration in the adjacent spinal segments. The TOPS System is a modern fusion alternative for lumbar spinal fusion that provides stability while preserving spinal motion in all directions. Contact a specialist in your area today to learn more!