A Nonsurgical Treatment Option For Lumbar Spinal Stenosis
Posted Dec 02 2009 12:00am
San Francisco Disc Herniation Doctor Comments:
We have been providing nonsurgical options for patients with lumbar stenosis for 18 years at Executive Express Chiropractic in the SF Financial District.
If you have been told you have spinal stenosis or foraminal stenosis, you most likely have had an MRI or cat scan of the lumbar spine. X-rays can also help determine if there is "bony" spinal stenosis (from degeneration)...but an MRI is the gold standard as it can allow your doctor to look at both the soft structures such as the spinal discs and nerves, as well as the bony structures.
Spinal stenosis, which occurs when either the diameter of the spinal canal or vertebral foramen becomes occluded or narrows because of spinal degeneration, bone or soft tissue fragments from previous surgeries, bulging or herniated discs, osteophytes, which are bone spurs that jut out from the edge of a vertebrae into the foramen.
A common symptom of spinal stenosis is what's called Neurogenic Claudication, which results in cramping or a feeling of weakness (and difficulty walking) from nerve compression/inflammation in the foramen, usually when standing. This is because when you stand, the vertebrae compress and if there is something in the foramen that should not be there, it can pinch the nerve. Usually, it will feel better when you sit.
So what can be done...do you need back surgery for spinal stenosis?
Well...it just depends, all cases are different. The first thing that needs to be determined is whether or not it is "bony stenosis" or "soft tissue stenosis"...and how bad is it? There are plenty of people walking around with both that will never ever have any symptoms.
However, you have symptoms and you have stenosis...so the question becomes..what can you do about it?
Lumbar stenosis is most common at "L4-L5" and "L5-S1". This is the area of the spine that bears the most weight.
If you have osteophytes (bone spurs) in the foramen you may be a surgical candidate. Sure, there are ways to get the inflammation down and open up the foramen (cortisone, fish oil, plant based diet, weight loss, nonsurgical spinal decompression, certain spinal exercises), but sometimes the only solution is surgery. But (in certain situations) you wont know if the other treatments can help unless you try them.
Chiropractic may help...it's certainly worth a shot. Physical therapy, acupuncture, specific exercises...or medical treatments, such as cortisone injections (as long as you don't get more than a few).
But the new gold standard for the nonsurgical treatment of herniated and bulging lumbar discs is a technology called nonsurgical spinal decompression. The machine we use is the DRX9000.
In fact, nonsurgical spinal decompression may help certain people with bony lumbar stenosis. Decompression can't do anything about the degeneration or bone spur...but it can help enlarge the disc space, elongate the spine and reduce inflammation of the nerve and soft tissues. All of these things allow the nerve to have more room.
Will this last? Who knows...but at least it leaves you whole and able to try other treatments if symptoms return. It's also very safe and gentle. If you are overweight and you go on a weight loss program and start some exercises after successful nonsurgical spinal decompression it may last forever. Hey...you can always have surgery. But once you have spinal fusion you can never try nonsurgical spinal decompression.