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. 

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

    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. 

    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.

    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.