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?

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. 

Say goodbye to spinal problems starting Now!

David danced at his son’s wedding

Bonnie explains why TOPS surgery was the right decision for her

Wade is back to hiking

Scott speaks about going to surgery

Regain your mobility with Premia Spine! Contact us now

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.