Spinal stenosis can lead to pain in your buttocks, legs, or feet that intensifies with movement or standing but eases when sitting down. Walking and standing may make matters worse, while sitting may improve issues.
Medication may help relieve your symptoms. Over-the-counter nonsteroidal anti-inflammatory drugs (such as aspirin, ibuprofen, and naproxen ) can reduce pain and inflammation to create more space for nerves.
Baclofen
Baclofen is a muscle relaxant used to help ease spasms and tightness of muscles caused by specific medical issues, such as multiple sclerosis or spinal cord injury/disease. While it cannot cure these problems, it can help improve mobility and alleviate pain. Baclofen works on the central nervous system (CNS) to produce its muscle-relaxant effects; it is available only through valid prescription and comes both as tablets and liquid. Always read and follow your prescription label directions before beginning or refilling!
Baclofen has been proven effective at decreasing spasticity in muscles affected by spinal cord conditions, including lumbar spinal stenosis. It alters the action of gamma-aminobutyric acid receptors located within spinal nerves and the brain. Decreasing excitatory neurotransmitters while stimulating inhibitory ones – thus reducing stiffness or tightness in muscles.
Patients unable to take baclofen by mouth may benefit from an implanted drug pump that administers it directly into the spinal fluid. This device, or intrathecal baclofen (ITB), consists of an internal pump positioned just under the skin near the abdomen with an attached catheter leading directly into the spinal canal – similar to an intravenous infusion of drugs such as IVIG. Once set up, this pump delivers a predetermined dosage at regular intervals daily and night for more precise dosing with fewer adverse side effects than oral baclofen. It allows for greater precision of dosing accuracy when dosing is concerned.
Cyclobenzaprine
Cyclobenzaprine is a muscle relaxant used to manage spasms associated with spinal stenosis. Additionally, it can relieve numbness and tingling in arms, legs, and buttocks by blocking pain signals to your brain. Cyclobenzaprine may be taken alone or with other medicines to treat spinal stenosis. Common side effects may include clumsiness, unsteadiness, confusion, dry mouth, constipation, and drowsiness. Methocarbamol is another muscle relaxant that may help alleviate spinal stenosis symptoms; its less sedating effect and lower abuse rate are distinct advantages over other prescription medications. It blocks pain signals while relieving numbness, tingling, and pain from damaged nerves while relieving numbness, tingling, and pain from damaged nerves; commonly reported side effects include drowsiness, dizziness, stomach upset, headache, and nausea.
People suffering from spinal stenosis can often manage the pain with over-the-counter anti-inflammatory drugs like aspirin, naproxen (Aleve), and ibuprofen (Motrin/Advil). General pain relievers like Tylenol may also help. Your physician may recommend antiseizure medicines like gabapentin or pregabalin to ease nerve damage-induced discomfort.
Spinal stenosis occurs when your spinal canal narrows, restricting spinal cord function and nerves that branch off it. You may develop spinal stenosis due to injury or degenerative changes as you age (spine degeneration). Lifestyle modifications may help you prevent or treat spinal stenosis effectively.
Methocarbamol
Methocarbamol is a muscle relaxant that alleviates pain and spasms by blocking brain pain signals. Compared with other muscle relaxants, Methocarbamol is less sedating, and abuse rates are lower; moreover, it has fewer side effects such as clumsiness, unsteadiness, dry mouth constipation, and confusion. Methocarbamol tablets come in 500 and 750 mg doses and should be taken at approximately the same time every day; its brand name Robaxin may be available.
This medication should only be taken as prescribed, by any instructions from your healthcare provider. As it may interact with other medicines or supplements you are taking, be sure to notify them. It may increase sedation when combined with narcotic painkillers, alcohol, or hypnotic drugs, leading to drowsiness, difficulty breathing, or even coma in severe cases.
It should be taken with care by people with liver or kidney issues; excessive doses could build up in their system and become harmful. Furthermore, pregnant and nursing mothers should avoid this medication.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Medication may help to alleviate the pain caused by spinal stenosis. Spine specialists usually advise nonsurgical treatments before considering surgery; NYU Langone spine specialists offer treatment plans, including medications, physical therapy, and other options.
Spinal stenosis occurs when the spinal canal (backbone) space narrows, leading to pressure on nerves and the spinal cord. It most frequently affects the neck and lower back area, often causing intense pain, numbness, tingling, or weakness in those affected.
Anti-inflammatory medications are among the most frequently prescribed treatments for stenosis. Typical examples are aspirin, naproxen, and ibuprofen – nonsteroidal anti-inflammatory drugs commonly referred to as NSAIDs – These medicines help relieve pain by decreasing inflammation in your spine and joints, allowing more space between vertebrae. Furthermore, NSAIDs block certain enzymes known as cyclooxygenase that promote prostaglandin production, which in turn promotes inflammation and blood flow.
If NSAIDs fail to offer sufficient relief, your doctor may recommend more substantial doses or different types of NSAIDs. They could also recommend analgesics, which relieve pain without reducing inflammation, or anti-seizure drugs like gabapentin and pregabalin that change how your brain sends pain signals to the spinal cord and can alleviate your discomfort by altering how pain signals travel from the brain to the spinal cord.
Tricyclic antidepressants
These medications alleviate depression and anxiety while relieving spinal stenosis pain, blocking serotonin reuptake to lessen pain signals in the spinal cord. TCAs typically come in small doses with gradual increases to avoid potential side effects – some common ones being Amitriptyline, imipramine, and Nortriptyline.
Antidepressants can be used to treat an array of conditions, from mood disorders like depression and bipolar disorder to anxiety, panic, attention-deficit hyperactivity disorder, and post-traumatic stress disorder; eating disorders like anorexia nervosa and bulimia nervosa; sleep problems like narcolepsy/narcoleptic/bedwetting as well as physical symptoms like muscle spasms. They may be taken alone or combined with other medication to manage pain, anxiety/depression more effectively.
Tricyclic antidepressants may be prescribed off-label to alleviate nerve-type pain caused by diabetes, shingles, fibromyalgia, and phantom limb syndrome. Available as tablets, capsules, or solutions, they have a sedating effect and may lead to dry mouth, blurred vision, constipation, dizziness, drowsiness, changes in blood pressure, heart rate, and electrocardiogram (ECG) abnormalities, and can interact with many drugs so always speak with your healthcare provider before starting them. They should never be taken during pregnancy or by those predisposed with preexisting conditions such as ischemic heart disease or a history of seizures. These could alter ECG abnormalities, and electrocardiogram abnormalities may also occur.
Epidural steroid injections
Steroid injections are potent painkillers that ease inflammation in tendons (tendinitis) or bursae (cushioning pads of tissue cushion muscles and bones in joints). Orthopedic specialists often administer them for shooting nerve pain caused by herniated disks or spinal stenosis, narrowing the space around the spinal cord.
Epidural Steroid Injections (ESI) combine anti-inflammatory medicine and anesthetic pain relief in one treatment session. The medication is injected directly into the epidural area of the spine – outside the protective sac surrounding the spinal cord and nerves – where numbing anesthetic relieves any pain during the procedure. At the same time, corticosteroid reduces inflammation gradually to help alleviate herniated disk or spinal stenosis pain relief.
An epidural steroid injection involves lying on an x-ray table. At the same time, your healthcare provider cleans the area where the needle will be inserted before inserting the needle under fluoroscopic guidance into your epidural space. After the procedure, any numbing agents that were applied will wear off, and you should take an over-the-counter painkiller or use ice as necessary if any discomfort remains post-injection.
Physical therapy
Suppose the pain from spinal stenosis does not improve with medication. In that case, your doctor may suggest physical therapy and exercises to strengthen your core and back muscles in order to alleviate pain and prevent future issues with your spine. Stop immediately if any exercise or stretch worsens your discomfort or increases numbness or tingling sensations.
Finding the source of your discomfort may require a medical exam and imaging tests. X-rays may reveal bone changes in the spine that make the space between vertebrae smaller, while magnetic resonance imaging (MRI), using large magnets and radio waves to create images of both hard and soft tissues within your body, can reveal damaged disks or tumors that could be contributing to it.
Suppose your doctor suspects spinal stenosis as the source of your symptoms. In that case, they will perform an initial physical exam and collect relevant health histories before ordering an appropriate CT scan or myelogram with a dye injection to visualize structures in your body and better understand your spinal cord and nerves. They may also recommend injecting a corticosteroid to reduce inflammation while an anesthetic helps relieve nerve pain to determine what area requires intervention.
