Spinal stenosis occurs when the spaces within the spine narrow, which may put pressure on the spinal cord and nerves. This condition most often appears in the neck or lower back and typically develops with age. It can lead to symptoms such as pain, numbness, weakness, or difficulty walking. Treatment decisions usually depend on symptom severity, location, and an individual’s health status. Three widely discussed treatment options include epidural steroid injections, spinal cord stimulation, and surgical procedures.
Epidural Steroid Injections
Epidural steroid injections deliver corticosteroid medication and a local anesthetic into the epidural space around the spinal cord and nerves to address pain and inflammation. A physician uses real-time imaging guidance to position the needle accurately. Relief from these injections differs among patients. Some experience improvement in pain and mobility lasting several months.
Common short-term side effects are mild soreness, temporary increase in pain, or a small rise in blood sugar, particularly among diabetic patients. Epidural injections are most beneficial for people whose symptoms are largely related to inflammation. They may assist patients in engaging more fully in other non-surgical treatments by reducing pain enough to facilitate movement.
Spinal Cord Stimulation
Spinal cord stimulation uses electrical pulses delivered by a device implanted near the spinal cord to disrupt pain signals traveling to the brain. The device consists of leads placed in the epidural space and a small pulse generator implanted under the skin. The system can be programmed to match a patient’s pain distribution and intensity.
Before permanent implantation, a trial period is conducted. Temporary leads are inserted, and the external pulse generator allows the patient to assess pain relief. If the trial provides substantial benefit, a patient may choose permanent implantation, with the generator placed under the skin.
Recovery from implantation takes about 4 to 6 weeks. This option is usually for individuals who do not respond to conservative treatments or who are not suited for surgery due to health reasons. Spinal cord stimulation may be especially relevant for those experiencing leg pain due to spinal stenosis, though some relief of back pain may also occur.
Surgical Procedures for Spinal Stenosis
Surgical options address the physical narrowing of the spinal canal or nerve passageways by removing or altering the structures causing compression. The primary goal is to make more space for the spinal cord or nerves. A laminectomy is the most common surgery for spinal stenosis. The surgeon removes the lamina and may address bone spurs, thickened ligaments, or herniated discs as needed. Laminectomies can be performed using open or minimally invasive methods.
There are also procedures that enlarge openings where nerve roots exit the spine and are sometimes used alone or with other decompressive surgeries. Spinal fusion may be needed if stability is affected by decompression. This process permanently joins two or more vertebrae using bone graft and metal hardware.
Speak With a Spine Expert
Choosing a treatment approach for spinal stenosis involves a comprehensive evaluation of symptoms and previous responses to non-surgical management. A spine specialist can review history, conduct a physical exam, interpret imaging studies, and discuss suitable options. An individualized strategy, developed with professional guidance, can enable many people to effectively manage spinal stenosis symptoms and pursue proper treatment.