A summary of stenosis, who treats it, how it’s managed and options that are non surgical

Who Treats Spinal Stenosis? And how is it diagnosed?

Stenosis is often brought up as a red flag in the case history.  X ray is a preliminary way to confirm the diagnosis, but often times an MRI [with or without contrast] is needed to know 100%.  A CT is often considered as a solid confirmation as well.  Without imaging, it can’t be confirmed as the diagnosis though.

Orthopedic doctors, rheumatologists, general practitioners, chiropractors, acupuncturists and massage therapists will all have their contribution to treatment.  Keep in mind though that permanent results are often not received with non surgical treatment.  Depending on the severity surgery can often times be a suggestion in treatment – the results of which can last quite a while.  In some cases the progression of growth just can’t be controlled without surgery.

If the non surgical approach is your preference [and should be a consideration when possible], you’ll likely get results but at that point you’ll likely have to adapt a lifestyle change where you use the therapy of your choice.  In this approach it’s more of a process than it is an event [such as surgery].

What Are Some Nonsurgical Treatments for Spinal Stenosis?

If there is no evidence of severe or progressive nerve involvement, your physician may prescribe one or more of the following conservative treatments:

• Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen (Motrin, Nuprin, Advil to reduce inflammation and relieve pain.
• Analgesics, such as acetaminophen (Tylenol), to relieve pain.
• Corticosteroid injections into the outermost of the membranes covering the spinal cord and nerve roots to reduce inflammation and treat acute pain that radiates to the hips or down a leg.
• Anesthetic injections, known as nerve blocks, near the affected nerve to temporarily relieve pain.
• Restricted activity (varies depending on extent of nerve involvement).
• Prescribed exercises and/or physical therapy to maintain motion of the spine, strengthen abdominal and back muscles, and build endurance, all of which help stabilize the spine. Some patients may be encouraged to try slowly progressive aerobic activity such as swimming or using exercise bicycles.
• A lumbar brace or corset to provide some support and help the patient regain mobility. This approach is sometimes used for patients with weak abdominal muscles or older patients with degeneration at several levels of the spine.

What Are Some Alternative Therapies for Spinal Stenosis?

• Chiropractic treatment—This treatment is based on the fact that inhibited movement in the spine reduces proper function.  This decrease in motion sends nociceptive [pain] signals to the brain; this is due primarily in the loss or reduction of proprioceptive [inhibited pain] signals…

Chiropractors may manipulate (adjust) the spine to restore normal spinal movement.  A few main points in considering chiropractic care is

1.       NO HVLA [High Velocity Low Amplitude] adjusting – not in the affected area of stenosis anyway.  This is the QUICK movement elicited by the doctor that often results in a cavitaion [a‘popping’ noise].  These quick forces [ in severe cases] can be too much when the body’s physiological and structural integrity don’t allow for it.  The main risk here is nerve damage.

a.      Techniques like this are :

i.      Diversified

ii.      Gonstead

iii.      Thompson, etc….

2.     LOW Velocity HIGH Amplitude [LVHA] is the gold standard in techniques to treat this condition.  This treatment will feel like a massage in many ways, but is very focused in joint mobilization.  Nerves and other tissues are able to stretch slowly which is why this ‘style’ of chiropractic is the only way to go when you have spinal stenosis.

a.      The treatment style or technique your chiropractor should and likely would use to practice in this case is:

i.      COX  [Flexion / Distraction]

ii.      SOT [Sacral Occipital Technique]