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Pinal Stenosis Treatment

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Depending on the severity of symptoms, spinal stenosis can often be managed through nonsurgical treatments.
The three most common non-surgical spinal stenosis treatments include:

Exercise

Activity modification

Epidural injections

Non-surgical Treatment for Spinal Stenosis


Non-surgical spinal stenosis treatment options for patients may include:

Exercises for Sciatica from Spinal Stenosis Video

Exercises. Although a suitable program ofspinal stenosis exercises may be helpful in


the hands of a good physical therapist, it is not curative. Even though stenosis
exercises are not a cure, however, it is very important for patients to remain active as
tolerated and not additionally debilitated from inactivity; therefore, an appropriate
spinal stenosis exercise program is a key part of any treatment program.

Activity modification. With this treatment for stenosis, patients are usually counseled
to avoid activities that cause adverse spinal stenosis symptoms. Patients are typically
more comfortable while flexed forward. Examples of activity modification for
treatment of spinal stenosis might include: walking while bent over and leaning on a
walker or shopping cart instead of walking upright; stationary biking (leaning forward
on the handlebars) instead of walking for exercise; sitting in a recliner instead of on a
straight-back chair.

Article continues below

Epidural Steroid Injections Video

Epidural injections. An injection of cortisone into the space outside the dura (the
epidural space) can temporarily relieve symptoms of spinal stenosis. While injections
can seldom be considered curative, these spinal stenosis treatments can alleviate the
pain in about 50% of cases. Up to three injections over a course of several months can
be tried. Although they are not considered diagnostic in and of themselves, generally,
if the pain caused by spinal stenosis is relieved by an epidural steroid injection, then
the patient can also be expected to have a good result if they later choose to have
spinal stenosis surgery.

In This Article:

What is Spinal Stenosis?

Spinal Anatomy and its Effects on Types of Spinal Stenosis

Spinal Stenosis Symptoms and Diagnosis

Spinal Stenosis Treatment

Spinal Stenosis Surgery

Spinal Stenosis Symptoms and Diagnosis Video

Additional Treatments for Spinal Stenosis

Spinal Stenosis Treatment Video


Anti-inflammatory medication (such as aspirin or ibuprofen) may be helpful in treating spinal
stenosis. Some physicians recommend a multiple B-complex vitamin with 1200 mcg of folic
acid daily, but this has not been substantiated in the medical literature as an effective
treatment for stenosis.
Some people may successfully manage the symptoms of spinal stenosis with the non-surgical
therapies either for a period of time or indefinitely. The key in choosing whether or not to
have surgery is the degree of physical disability and disabling pain from lumbar spinal
stenosis.

See When to See a Surgeon for Spinal Stenosis

As a guideline, when the (usually elderly) patient can no longer walk sufficiently to care for
himself or herself (such as to go shopping for essentials), then lumbar spinal stenosis surgery
is usually recommended. Surgery for lumbar stenosis is mainly designed to increase a
patients activity tolerance, so he or she can do more activity with less pain.
Next Page: Spinal Stenosis Surgery
PAGES:

Related Articles:

Cervical Foraminal Stenosis

Cervical Stenosis with Myelopathy

Lumbar Spinal Stenosis: A Definitive Guide

Lumbar Decompression Back Surgery

Living with Lumbar Spinal Stenosis

Related Videos:

X-STOP Interactive Video


From a surgeons viewpoint see how X-STOP, a minimally invasive surgical procedure, is
designed to relieve symptoms of lumbar spinal stenosis.

Sciatica Exercises for Spinal Stenosis Video


Learn the correct technique for performing stretches and exercises to increase back strength
and relieve sciatica caused by spinal stenosis.

Treatment for Spinal Stenosis Video


Learn more about spinal stenosis and how to treat it in this informative video.
A Spine-health.com Peer Reviewed Article
Written by Charles D. Ray, MD

B LO G H O M E

B AC K PA I N S T O R E

SPINAL STENOSIS SITE

A BO U T

Spinal Stenosis Blog


Thoracic Spinal Stenosis
Breathing Difficulties and Other
Symptoms
by LMATTHEWS on AUGUST 29, 2012

The thoracic spine is connected to the ribs and stenosis here can cause
breathing difficulties.

Thoracic spinal stenosis may be less common


than lumbar spinal stenosisor cervical spinal
stenosis but it can still cause pain along with a
variety of other symptoms. The thoracic spine is
made up of twelve vertebrae starting from the
shoulders and going down through the rib cage to
the lumbar spine. The spinal cord is protected inside
this spinal column and spinal nerves branch off and
exit the spine through foramina in the thoracic
vertebrae.

Effects of Stenosis in the Thoracic Spine


Where stenosis (narrowing) of these foramina occurs the nerves
can become trapped and pain, altered sensation, motor difficulties
and even organ dysfunction may arise as a result. Thoracic spinal
stenosis can cause breathing difficulties in some patients and,
whilst rare, may require immediate attention to decompress the
spine. Even minor trauma to the back can cause spinal cord injury
(SCI) in those with spinal stenosis and an SCI at the thoracic level
could lead to paralysis of the intercostal muscles and other
muscles involved in breathing.

Symptoms of Thoracic Spinal Stenosis


Nerves which exit the thoracic spine are not just responsible for
innervating respiratory muscles, however, they also extend far
into the body to organs and other muscles. As such, injury at the
mid-level of the spine, causing thoracic spinal stenosis and nerve
or spinal cord compression can have an effect at any level below
the site of injury, even into the legs. Total loss of sensation may
occur or patients may experience intermittent numbness and
paraesthesia with progressive weakness if this pins and needles
sensation is not adequately addressed.

Muscle Atrophy, Paralysis and Breathing


Problems
Thoracic spinal stenosis that goes untreated can lead to
irreversible neurological injury and atrophy of the muscles as they
are no longer receiving signals from motor neurons. Respiratory
difficulties and weakness in the legs are two possible symptoms
of thoracic spinal stenosis that has led to muscle weakness or
paralysis. This may begin as muscle spasms, cramps, and
uncontrollable movements or gait disturbances. Continued spasms
of the muscles may trigger muscle fatigue and pain, followed by
weakness. Where these symptoms are severe it is sometimes
necessary to undergo back surgery to decompress the thoracic
spine in an attempt to restore functional gait and mobility.

Diagnosing Thoracic Spinal Stenosis

Another possible sign of thoracic spinal stenosis is an acute issue


of orthostatic hypotension. This is a condition involving low
blood pressure when changing position, such as when standing
suddenly after sitting or lying down. Blood pressure disturbances

are connected to thoracic spinal stenosis in some cases due to


damage to the nerves that control the muscle tone of blood
vessels. Dizziness may not seem an obvious sign of spinal
stenosis but it may be an important diagnostic sign in those with
intermittent and disparate symptoms.

Causes of Thoracic Spinal Stenosis


Thoracic spinal stenosis may be a result of back trauma,
congenital defect, wear and tear, or even the knock-on effects
from back surgery in the lumbar or cervical spine. Generally,
thoracic spinal stenosis is less common than stenosis in the other
spinal sections due to its relative stability and, thus, reduced wear
and tear. However, where it does arise, the symptoms of stenosis
in the thoracic spine can be quite different from those expected
from stenosis in the neck or lower back. The usual culprits
of degenerative disc disease, bone spurs, arthritis, and disc
herniation can all cause thoracic spinal stenosis, as can ligament
calcification and adjacent segment syndrome after back surgery.

Treating Thoracic Spinal Stenosis


Treatment for thoracic spinal stenosis depends on the severity and
progression of the condition and may involve physical therapy,
pain medications and other conservative options for several
months before back surgery is suggested. In some cases it may
simply be a matter of time and rest or limited activity that is
needed to allow the spine to heal after incurring some trauma.
A back brace could be helpful for some patients but may actually
hinder the healing process and lead to further muscle atrophy in
others so it is important to consult a qualified physician before
applying any treatments for thoracic spinal stenosis.

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