To diagnose spinal stenosis, your doctor may ask you about signs and symptoms, discuss your medical history, and conduct a physical examination. He or she may order several imaging tests to help pinpoint the cause of your signs and symptoms.
These tests may include:
- X-rays. An X-ray of your back can reveal bony changes, such as bone spurs that may be narrowing the space within the spinal canal. Each X-ray involves a small exposure to radiation.
- Magnetic resonance imaging (MRI). An MRI uses a powerful magnet and radio waves to produce cross-sectional images of your spine. The test can detect damage to your disks and ligaments, as well as the presence of tumors. Most important, it can show where the nerves in the spinal cord are being pressured.
- CT or CT myelogram. If you can’t have an MRI, your doctor may recommend computerized tomography (CT), a test that combines X-ray images taken from many different angles to produce detailed, cross-sectional images of your body. In a CT myelogram, the CT scan is conducted after a contrast dye is injected. The dye outlines the spinal cord and nerves, and it can reveal herniated disks, bone spurs and tumors.
Spinal stenosis surgery
Treatment for spinal stenosis depends on the location of the stenosis and the severity of your signs and symptoms.
Talk to your doctor about the treatment that’s best for your situation. If your symptoms are mild or you aren’t experiencing any, your doctor may monitor your condition with regular follow-up appointments. He or she may offer some self-care tips that you can do at home. If these don’t help, he or she may recommend medications or physical therapy. Surgery may be an option if other treatments haven’t helped.
Your doctor may prescribe:
- Pain relievers. Pain medications such as ibuprofen (Advil, Motrin IB, others), naproxen (Aleve, others) and acetaminophen (Tylenol, others) may be used temporarily to ease the discomfort of spinal stenosis. They are typically recommended for a short time only, as there’s little evidence of benefit from long-term use.
- Antidepressants. Nightly doses of tricyclic antidepressants, such as amitriptyline, can help ease chronic pain.
- Anti-seizure drugs. Some anti-seizure drugs, such as gabapentin (Neurontin) and pregabalin (Lyrica), are used to reduce pain caused by damaged nerves.
- Opioids. Drugs that contain codeine-related drugs such as oxycodone (Oxycontin, Roxicodone) and hydrocodone (Norco, Vicodin) may be useful for short-term pain relief. Opioids may also be considered cautiously for long-term treatment. But they carry the risk of serious side effects, including becoming habit forming.
It’s common for people who have spinal stenosis to become less active, in an effort to reduce pain. But that can lead to muscle weakness, which can result in more pain. A physical therapist can teach you exercises that may help:
- Build up your strength and endurance
- Maintain the flexibility and stability of your spine
- Improve your balance
Integrative medicine and alternative therapies may be used with conventional treatments to help you cope with spinal stenosis pain. Examples include:
- Massage therapy
- Chiropractic treatment
Your nerve roots may become irritated and swollen at the spots where they are being pinched. Injecting a steroid medication (corticosteroid) into the space around impingement can help reduce the inflammation and relieve some of the pain.
Other treatment procedures may relieve the pain associated with spinal stenosis.
Call for an Evaluation
Call our office to have one of our board certified physicians evaluate your condition. Our physicians specialize in pain management and offer many options for pain relief. Our phone number is (510) 582-8555.