Lumbar Spinal Stenosis Treatment Options

The symptoms of lumbar spinal stenosis (LSS) are pretty clear: severe pain when walking more than 50 feet, and relief when bending over or sitting. And the cause is usually clear-cut, too; it’s another sign of aging.

The good news is there are effective outpatient surgical procedures available when physical therapy, chiropractic and other conservative measures have failed to ease the pain of spinal stenosis.

What is Lumbar Spinal Stenosis?

LSS is a degenerative condition that typically comes from a lifetime of the lower spine supporting the supper body. As people age, the discs between the vertebrae, or spinal bones, become worn down. This causes the spinal canal to slowly narrow, effectively squeezingthe nerves that exit the spine. This pressure often leads to tingling, numbness, or sciatic nerve pain that radiates to the buttock, leg and groin. It can be excruciating.

People with LSS typically cannot walk father than 50 feet without feeling this pain and find relief when sitting down or leaning forward. A typical scenario is the older person at the grocery store hunching over a shopping cart to relieve the pain.Left untreated, muscle weakness, loss of reflexes, and sometimes a condition called foot drop can develop.

The goal in treating LSS with surgery is to gently widen the narrowed opening in the spinal canal, giving the spinal cord and nerves more room to function normally. While injections of numbing medication can keep the pain away for a certain period of time, sometimes surgery is the best option.

Minimally Invasive Spine Surgery (MISS)

Skilled surgeons no longer need to treat low-back stenosis with traditional open back surgery, which involves a 5- to 6-inch incision and the cutting of muscles to reach the spine. Instead, specialists can use narrow dilation tubes that spread muscles like a curtain, and tiny endoscopic instruments outfitted with cameras. This approach avoids damage to muscle and tissue.

“A cut or torn muscle is essentially damaged forever. It becomes weak and never functions the same way again,” says Dr. James St. Louis, an orthopedic spine surgeon with Physician Partners of American Minimally Invasive Spine Group. “In minimally invasive spine procedures, the muscle fibers are left intact. There’s less bleeding and pain, and the recovery is days or weeks, not months.”

A laser maybe used in these procedures to ablate pain-causing nerves and shrink bulging discs that cause spinal stenosis.

Foraminotomy – This procedure increases the width of the intervertebral foramen, or opening between a pair of vertebrae in the treatment area. A small tool called a Rongeur is used to remove small slivers of spinal bone.It allows more room for the exiting nerve and alleviates the painful compression.Thisis a minimally invasive outpatient procedure that requires only two or three stitches and allows the patient to go home the same day.

Laminotomy – This procedure targets the lamina, the bony cover of the spinal canal. The surgeon removes a small part of the lamina to relieve pressure on the nerve exiting the spinal cord. In experienced hands, this procedure will not harm the structure of the spine.

Interspinous Process Spacers for Lumbar Spinal Stenosis

Another alternative to traditional surgery is a spacer, which helps keep spinal bones separated while the patient is standing. This small device, implanted by an experienced surgeon, relieves pressure on the spinal nerves. Its effectiveness has been validated by years of clinical research and is FDA approved.

While the idea of “back surgery” may seem scary, minimally invasive procedures are nothing like traditional open back surgery. They are highly effective and safe, allowing the patient to walk out of the surgery center the same day and heal quickly. Most people report a steep reduction in pain and some are immediately pain free.

Spinal Cord Stimulation Can Relieve Arachnoiditis

Arachnoiditis is not related to spiders, but one of its symptoms is a creepy-crawly sensation. It is a rare condition of a web-like spinal membrane that is difficult to treat; however, spinal cord stimulation is proving to be a highly effective to relieve arachnoiditis symptoms.

With only about 11,000 cases diagnosed each year, this condition causes scarring of the layers surrounding the spinal nerves. Inflammation causes the nerves to stick together and create scar tissue, which presses against the nerve roots that exit the spine.

What Does Arachnoiditis Feel Like?

The condition presents differently in everyone. It can be as mild as a creeping skin sensation or as severe as muscle cramps and spams or sharp electric shock-like pain. In some people, it can cause bladder, bowel or sexual problems.“Sometimes the same patient can have all these symptoms at once or at different times,” says Dr. Abraham Rivera, Chief Medical Officer of Physician Partners of America in Tampa. “It’s the kind of condition that few doctors ever encounter.”

Arachnoiditis treatment

Arachnoiditis is commonly linked to impurities that enter the fluid surrounding the spinal column. This can happen accidentally during medical procedures like spinal taps, myelograms and epidurals. It can also be a unique reaction to preservatives used in certain injectable medicine.

New Ways to Treat Arachnoiditis

Prescription opioid medication has been a go-to treatment for arachnoiditis pain relief, but the side effects of a systemic treatment can outweigh the temporary relief. Interventional pain management specialists, who treat the root of pain conditions, have found greater success with spinal cord stimulation (SCS). Also known as neurostimulation, this treatment delivers a mild electrical current to the affected area. This current serves to counter the pain signals to the brain with a light tingling.

Spinal cord stimulators are implanted in a minimally invasive procedure performed outpatient, meaning the patient can go home the same day. The devicecombines a thin, flexible lead attached to a small generator placed under the skin. The patient controls the intensity of the stimulation using a handheld Bluetooth device. Some generators are changed out every few years, but the newest models are externally rechargeable.

How Does Spinal Cord Stimulation Work?

Spinal cord stimulation therapy begins with a trial period:temporary electrodes are put in place using careful x-ray guidance, and the patient controls the current using an external device.

If both patient and physician agree that the trial offers adequate pain relief, the permanent device is implanted in the nerve fibers of the spinal cord. The generator is placed under the skin in the abdomen or lower back, and the two are connected with an extension wire.

Spinal cord stimulators are one of the few fully reversible chronic pain treatments. A skilled physician can remove the lead and generator in a short outpatient procedure. The lead is threaded down the spine in the epidural space, and the generator is placed under the skin in the lower back. The two are connected by a thin, flexible extension wire. The patient may be awakened briefly during the procedure to make sure the right nerves are being targeted.

Spinal cord stimulation is successfully used to treat many other severe, chronic pain conditions, such as lasting pain after back surgery (failed back syndrome), peripheral neuropathy and complex regional pain syndrome. Results also show promise for arachnoiditis,

“For the right patient, spinal cord stimulation can successfully treat the symptoms associated with arachnoiditis,” says Dr. Rivera.

Social Security Coverage for Spinal Stenosis

Social Security Covers Spinal Stenosis?

If you experience spinal stenosis and are unable to work, you may be eligible for Social Security disability benefits. The Social Security Administration (SSA) offers monthly disability benefits for people who are no longer able to work due to a serious illness. The good news for you is spinal disorders are some of the most commonly approved conditions. Continue reading “Social Security Coverage for Spinal Stenosis” »

How Sleep Deprivation Impacts Back Pain

Even though the average adult needs seven to eight hours of sleep, many people struggle to get that many hours in because of pain. Rest can become even more difficult because a lack of sleep influences both pain levels and the effectiveness of pain medications.

While pain perception varies from person to person, it can also change based on sleep quality and quantity. Researchers have tested the theory that sleep loss affects pain perception in a number of different studies, including one that compared pain sensitivity between a group of people that got nine hours of sleep and another got seven. Technically, both groups got an adequate amount of sleep, yet the group that increased their sleep time showed a 25 percent higher pain tolerance. Other studies have compared pain sensitivity between groups that got half the recommended amount of sleep or got no sleep at all. Every study showed that, in general, as the amount of sleep goes down the body’s sensitivity to pain goes up.

Pain tolerance isn’t the only way that sleep deprivation affects back pain. It also influences the body’s response to pain medication.

A study published in Experimental and Clinical Psychopharmacology explored the impact of sleep on the effectiveness of codeine. All participants took codeine but only half got a full night’s rest. Those who didn’t get enough sleep did not tolerate pain as well as those who did. Because lack of sleep increases pain and reduces the effectiveness of pain medications, sleep becomes more than a luxury and enters the realm of being a partner in pain management.

Everything from daytime habits and behaviors to bedroom conditions can influence sleep and, therefore, back pain. To provide the best chance at getting a good night’s rest, the right products and equipment need to be in the bedroom. For example, a mattress that supports your back and preferred sleep style can reduce wakefulness. A dark, quiet bedroom can help keep outside noises and distractions from interfering with sleep.

Behaviors and habits that support good sleep can also become part of reducing back pain. For many people, getting better sleep means developing a consistent sleep schedule. Going to bed at the same time every night and waking up at the same time each morning helps the body correctly time the release of hormones. For those who find it difficult to fall asleep, a bedtime routine can make a big difference. It gives both mind and body a chance to relieve stress while triggering the release of sleep hormones.

Diet can also influence the sleep-wake cycle. High-fat, heavy foods eaten close to bedtime can disrupt digestion and be uncomfortable. Caffeine and other stimulants eaten within four hours of bedtime can block sleep hormones. However, there are foods that promote the production of sleep hormones like dairy products, almonds, and bananas that make good late-night snacks.

Exercise can also affect how well you sleep. Regular activity wears the body out so it’s more tired at night. It also helps with weight management, muscle strength, flexibility, and endurance, all of which can help reduce back pain. Those who suffer from back pain should consult a physician to find appropriate exercises for their age, weight, and pain issues.

A focus on high-quality sleep may not eliminate back or neck pain, but it can certainly help bring it to manageable levels and allow pain medications to take full effect.


The best tips for managing chronic back pain

gut health back pain probiotics for ankylosing spondylitis and rheumatoid arthritis

Photo via Pixabay by Whitesession For the millions of Americans who are living with chronic pain every day, it can be difficult to find the right coping methods for sustainable living. Link to this post!

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Back Pain – Is it a Tumor?

spinal cancer back pain symptomsSpinal cancer is not the typical diagnosis when back pain strikes, but there are some symptoms that are red flags for a tumor or tumors in the spine. Spotting cancer early gives you the best chance of success, but due to the varying symptoms of cancer in the spine, and the relatively frequent occurrence of uncomplicated back pain, many people are not diagnosed until a tumor has already become quite large or metastasised.

If back pain persists, worsens, and is unresponsive to rest and conservative treatment, and is accompanied by the following symptoms, it is definitely time to talk to your physician about tests for cancer. Continue reading “Back Pain – Is it a Tumor?” »

Pain Management Options for Spinal Stenosis

Spinal stenosis is a very common ailment for people the world over and the pain can range from uncomfortable to intolerable. No matter what level of pain you experience with spinal stenosis, you will undoubtedly be in search of a way to treat it. Naturally, as it is such a common occurrence, there are a number of different treatment methods that you can try out yourself ranging from medication to more holistic approaches. Continue reading “Pain Management Options for Spinal Stenosis” »

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Nerve Pain and Quantum Theory – How a New Pain Management Protocol Could Revolutionise Peripheral Neuropathy Treatment

peripheral neuropathy and quantum theory for pain reliefWhat could quantum theory have to do with nerve pain? Well, according to a presentation given at the American Academy of Pain Management (AAPM) 25th Annual Clinical Meeting, quite a lot, actually. Whether this new direction for pain management will end up benefiting those with pain resulting from spinal stenosis remains to be seen, but it sure looks promising as a way of kicking the painkillers. Continue reading “Nerve Pain and Quantum Theory – How a New Pain Management Protocol Could Revolutionise Peripheral Neuropathy Treatment” »

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Do You Need a Lower Epidural Steroid Dose if You Have Diabetes?

epidural steroids and diabetes in spinal stenosisEpidural steroid injections for back pain have long been a popular way of treating spinal stenosis related to inflammation in the lumbar spine. The safety of these injections has, especially in the past couple of years, been called into question numerous times, and one such concern is the documented effect on blood glucose that occurs after epidural steroid injections. Continue reading “Do You Need a Lower Epidural Steroid Dose if You Have Diabetes?” »