Spinal stenosis is a pain condition that affects an estimated 500,000 people in the U.S. While some cases are mild and have little impact on daily life, other people experience debilitating pain and limited mobility. If you or someone you love is suffering, these are some of the best treatments for spinal stenosis.
What is spinal stenosis?
Spinal stenosis is a narrowing of the spine that occurs most often in the lower back (but can also occur in the cervical spine). This narrowing eventually begins to crowd the spinal cord and nerves in the spinal column. When this happens, radiating pain and mobility issues can quickly follow.
People over 65 are most at risk for spinal stenosis, but scoliosis and hypertension can contribute to its development also. The primary symptoms of spinal stenosis include:
- Radiating pain (called sciatica when it occurs in the lower back)
- Numbness or tingling in the arms, hands, legs, or feet
- Weakness in the extremities
- Neck pain (in cervical spinal stenosis)
- Clumsiness in the arms and hands (in cervical spinal stenosis)
If nerve compression is severe and untreated, it can lead to loss of bowel and bladder control, permanent damage, or even paralysis.
What are the best treatments for spinal stenosis?
The best spinal stenosis treatments are as individual as the person with this pain condition. There is no one miracle treatment that works for everyone. The best results occur when multiple treatments are put into place together.
Here’s where to get started, along with answers to frequently-asked questions.
Is walking good for spinal stenosis?
While some people might want to hit the couch when the pain of spinal stenosis comes on, a better idea is to lace up your shoes and hit the road. Walking is a full-body, low-impact exercise that improves overall health. The benefits of walking — especially in nature, if you can manage it — are countless.
- Group walks play a role in “undoing” the stressful effects of chronic pain
- Walking can ease anxiety and depression, which helps in treating pain conditions
- Exercise is not only good for spinal stenosis — it can provide the same level of pain relief as medication
- Walking not only decreases pain; it also increases quality of life
Walking is free, low-impact, available to most everyone, and a great primary treatment for spinal stenosis.
Stretches for spinal stenosis
Want one of the best spinal stenosis treatments that doesn’t cost a thing and is available to anyone at any level of fitness? Stretches. Targeted spinal stenosis exercises can help lengthen the spine and relieve pressure on your nerves.
Flexion exercises in particular decreased pain and lowered the risk of disability in people with spinal stenosis. Core stability stretches and exercises also resulted in an increase in walking capacity.
Flexion exercises bring space between the vertebrae, and core stability exercise helps build muscles to keep that space open. These exercises are portable, requiring little to no equipment, and can be done wherever you have space.
Yoga for spinal stenosis
For lower back pain, yoga is hard to beat. Yoga builds long, strong muscles and a tall, graceful spine. When it comes to yoga for spinal stenosis, research is growing.
- For both neck and lower back pain, Iyengar yoga outperforms other interventions when it comes to short-term pain relief and mobility
- Stretching in yoga improves gait, decreases pain, and increases well-being and the ability to deal with the mental aspects of pain
Overall, yoga is a great way to relax and manage the physical, mental, and emotional sides of chronic pain.
Back brace for spinal stenosis
In your everyday life, a simple back brace for spinal stenosis can be a lifesaver.
Note: This treatment does not work to fix the underlying mechanical issue; it’s a comfort measure that you can put in place as your back heals.
Acupuncture for spinal stenosis
How could medical practitioners working over 3,000 years ago have developed a treatment for spinal stenosis? Instead of looking only at symptoms, traditional Chinese medical doctors viewed the body as a whole, with energy lines called meridians running through it. When one of these lines becomes blocked, the energy (or Qi, pronounced “chee”) cannot flow. This causes pain and disease. Using hair-thin needles, acupuncture targets specific points in the body to release stuck Qi.
Western medicine has found that acupuncture creates a neurological healing response. It’s not well understood exactly how acupuncture works, but in a 2018 study, people receiving acupuncture for spinal stenosis had less pain and better physical function than the exercise and medication groups.
As a standalone therapy for sciatic pain, acupuncture relieved pain in a majority of patients in another 2015 study. Because sciatica is one of the primary symptoms of spinal stenosis, this is a promising result.
Massage for spinal stenosis
Massage for spinal stenosis does not have much focused research, but there is evidence that massage can help for non-specific lower back pain. One study found that weekly massage over a ten-week period provided pain relief for up to six months.
Other studies have supported this finding. It may be that massage therapy increases circulation in the area being massaged. Better circulation is associated with faster healing.
Another potential reason for massage’s healing touch is the relaxation and stress relief that massage provides. Struggling with chronic pain is exhausting. Massage offers a chance to get away from that struggle, one hour at a time.
Can a chiropractor help with spinal stenosis?
It makes sense to turn to a chiropractor when it comes to the structural integrity of the spine. After all, a chiropractor’s work focuses on correcting alignment in the spine that leads to pain or disease.
Since it is common to see a chiropractor for sciatica, it stands to reason that regular visits to the chiropractor can help with spinal stenosis.
Physical therapy for spinal stenosis
While all of the above treatments can have a positive effect on spinal stenosis, a 2019 study found that the biggest improvements occurred in those participating in physical therapy.
Working with a physical therapist means that exercise is specifically targeted to you and your particular condition. Of course it’s beneficial to move your body, but a physical therapist takes into consideration your starting point, the condition you are trying to improve, and other lifestyle factors or underlying health conditions. They can then develop specific exercises, just for you, and teach you how to do them properly.
This also gives you the most bang for your exercise buck — no more sloppy planks or half-hearted stretches when your physical therapist is standing next to you!
Physical therapy is another way to re-learn how to use your body in support of good health. And it just so happens to be one of the best treatments for spinal stenosis — one study in 2015 found that physical therapy had better outcomes than surgery when treating spinal stenosis.
Injections for spinal stenosis
One of the most challenging things about spinal stenosis treatments is that the person in pain is sometimes so debilitated that nothing has a chance to improve. Pain levels make it impossible to begin exercise or physical therapy. That’s where injections for spinal stenosis can help.
Injections for spinal stenosis consist of a corticosteroid to control inflammation and an anesthetic injected into the area above the affected nerve. This injection does not correct the underlying spinal stenosis, but it does give the person in pain some relief so that other treatments can begin.
Research has found that epidural steroid injections have both short- and long-term benefits in terms of pain relief and mobility. For people concerned about the side effects of corticosteroids, another study found that lidocaine-only injections offered the same benefits as lidocaine and a steroid.
While many people use injections as a long-term pain solution, others might receive only one or two in combination with other spinal stenosis treatments.
Vertiflex procedure for spinal stenosis
The Vertiflex procedure for spinal stenosis (also called the Superion® implant) is a new way to increase the space between the vertebrae — space that may collapse as spinal stenosis progresses.
This new procedure uses a small spacer inserted between the spinous processes (those bumps you can feel on your back). This spacer relieves pressure on the nerves, which in turn relieves pain and other symptoms of spinal stenosis.
In a long-term study of the Vertiflex procedure for spinal stenosis, 90% of study participants were pleased with their pain relief. Another study found that people were able to reduce their opioid intake by 85% after the Superion® implant was placed. All of this research builds on one of the very first studies — a two-year look that found pain score improvements similar to the usual first-line treatment of spinal stenosis.
This procedure is considered minimally invasive and only takes about 30 minutes. It can be a good option for people who are not finding relief from more conservative treatments but who also would like to avoid surgery.
Surgery for spinal stenosis
The big question: should I have surgery for spinal stenosis?
Surgery is generally a treatment of last resort, only suggested in cases where other measures have provided no relief (or when symptoms are getting worse). There are several different types of surgery that can help severe cases.
- Laminectomy: This involves removing part of the vertebrae (and potentially bone spurs and ligaments) compressing the nerves
- Laminoplasty: Laminoplasty is for cervical spinal stenosis, removing part of the bone and inserting plates and screws to maintain space
- Foraminotomy: Nerve roots exit the vertebra through the foramen, and this surgery removes bone to make more space there
Spinal fusion is offered when other surgeries and treatments have not helped maintain the space in the spine. This procedure joins two or more vertebrae to create stability and prevent further compression or deterioration in the spine.
New spinal stenosis treatments
The LimiFlex clinical trial has been in progress since 2017 and is focusing on a new type of spinal fusion. This treatment is specifically for people with spinal stenosis as a result of degenerative spondylolisthesis. The study will follow participants for five years, so this treatment is still on the horizon.
Another systematic review examining the safety and effectiveness of acupotomy has been underway since 2019. Acupotomy is a form of acupuncture that uses a scalpel-like needle to break up more muscle adhesions. Researchers hope to find a treatment for spinal stenosis like this that is less invasive and has fewer potential risks.
Rounding out potential spinal stenosis treatments is stem cell therapy. Injecting mesenchymal stem cells derived from adult fat and bone tissue may help repair damage done by spinal stenosis. This treatment focuses on repairing the cause of pain, not just treating symptoms.
These treatments may not be available yet, but talk to your doctor to learn more.
Find help for your spinal stenosis pain
What are the best treatments for spinal stenosis? The ones that work for you. This might be a combination of several treatments working together to relieve pain, increase mobility, and improve your quality of life.