Nonsurgical Treatment for Spinal Stenosis

Many people with mild spinal stenosis find that nonsurgical treatments such as pain medication and physical therapy relieve symptoms and help them remain active. NYU Langone spine specialists work with experts in pain management, rehabilitation, and orthotics to create a treatment plan.

Medication

Your doctor may recommend one or more types of medication to relieve pain associated with nerve compression.

Nonsteroidal Anti-inflammatory Drugs

Nonsteroidal anti-inflammatory drugs—commonly called NSAIDs—relieve pain by reducing inflammation of nerve roots and spine joints, thereby creating more space in the spinal canal. Types of NSAIDs include ibuprofen, aspirin, and naproxen.

If over-the-counter medications aren’t strong enough to relieve your pain, your doctor may prescribe a stronger dose.

Corticosteroids

Corticosteroids are anti-inflammatory medications that can reduce swelling and irritation in nerves and the spinal cord, relieving pain.

Doctors typically prescribe a course of corticosteroids taken by mouth for five or six days and reassess your symptoms before recommending further treatment. Many people experience relief from arm or leg pain within a few days.

Neuroleptics

Doctors may recommend neuroleptic medications, which stabilize overactive neurons within the spinal cord, to relieve arm or leg pain associated with nerve compression. How neuroleptics relieve this pain is not well understood, but some people find that taking a neuroleptic every day by mouth alleviates discomfort caused by spinal stenosis.

The length of time a doctor prescribes neuroleptics varies and is determined by the severity of your arm or leg pain, the presence of unusual sensations such as tingling or numbness, and whether the medication provides relief in the first four weeks.

Physical Therapy

Physical therapy designed to modify your posture may help reduce compression of nerves in the lumbar spine and alleviate pain. At NYU Langone, therapists who specialize in treating people with spine conditions can demonstrate simple exercises for strengthening the core muscles in the abdomen and thighs and stretching muscles in the back.

These exercises help to slightly modify the spine’s lumbar curve in a way that opens up the spinal canal. Any exercises that require bending backward should be avoided, as extension may make the symptoms of spinal stenosis worse.

Exercise also strengthens the core muscles in the back, abdomen, and buttocks that provide structural support for the spine. If these muscles are weak, it takes more energy for the body to stand and walk, which can cause muscle pain, in addition to the pain caused by spinal stenosis.

Exercise also strengthens and stabilizes the neck, which may reduce pain caused by cervical stenosis. Our physiatrists—doctors who specialize in rehabilitation medicine—and therapists can show you simple exercises you can do at home, even while sitting in an office chair.

Though physical therapy may relieve spinal stenosis symptoms, it is generally not a long-term treatment. Exercise does not address the anatomical cause of stenosis in the spinal canal.

Integrative Therapies

Our physiatrists offer integrative services to complement physical therapy, relieve pain, and improve your sense of wellbeing. These include heat, massage, acupuncture, and meditation. Transcutaneous electrical nerve stimulation, or TENS, which uses a low-voltage electrical current to stimulate the production of endorphins, the body’s natural pain relievers, may also be an option.

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