What Are the Best Spinal Stenosis Treatment Options for Pain Relief?
Get in-depth answers to frequently asked questions about treating spinal stenosis from a trusted source: IBJI’s Dr. Adam C. Young, a board-certified anesthesiologist and interventional pain management physician.
The latest spinal stenosis treatment options can relieve the pain caused by narrowing within the spinal canal. Spinal stenosis is common and occurs as we age, according to Adam Young, MD, an interventional pain management physician.
Dr. Young helps patients enjoy more comfortable and convenient lives, improving quality by reducing pain symptoms. He understands the complex nature of pain and the psychological stress it can cause.
Read on to hear more from Dr. Young about this common complaint among older patients and the spinal stenosis treatment options available today to help alleviate this pain.
Pain Management Expertise for Spinal Stenosis
Dr. Young treats patients of all ages who present with various pain ailments. He sees patients at the IBJI Morton Grove office, where he can perform many pain-relieving procedures.
Dr. Young offers a long list of treatment options, including steroid injections for joint pain, nerve blocks, radiofrequency ablation along the spine and joints, spinal stenosis treatments, compression fracture treatments, and spinal cord and DRG stimulation.
Non-Invasive Care for Spinal Stenosis
Dr. Young always considers the safety of any intervention when treating pain, highlighting the lower risks of many of these spinal stenosis treatment options.
“There are an increasing number of options that exist to treat spinal stenosis, and most patients will be a candidate for one of them,” he says.
What Is Minimally Invasive Lumbar Decompression?
MILD is another name for minimally invasive lumbar decompression.
Hear Dr. Young discuss this procedure at 18:48 during his pain management webinar
“When we talk about side effects, the minimally invasive lumbar decompression procedure has a safety profile consistent with an epidural injection, which is exceptionally low,” he says.
Dr. Young explains that the red triangle (in the photo) is the narrowed canal. “That’s a narrowed spinal canal. Normally it’s much larger and very round. That thick black piece of tissue is a specific ligament that stretches from the base of our head down to our tailbone. That ligament is a full length and stays that way our entire lives. As we age and decrease in height over time, the ligament starts to bunch up.”
The minimally invasive lumbar decompression procedure can be an option if that ligament is part of the problem, he explains. “This is another tool in our toolbelt in managing spinal stenosis,” he says. “It’s a simple outpatient procedure that is very safe.”
Minimally invasive lumbar decompression has become a popular spinal stenosis treatment option, with many patients showing interest in it.
“It’s a nice option for patients interested in something more than epidural injections to treat their spinal stenosis. And they’re not prepared for spine surgery that requires hospitalization or an extended recovery period,” Dr. Young says.
“A lot of people don’t realize that they are weak or deconditioned, so I recommend physical therapy afterward to regain strength and stamina. Patients who have good results two months following the minimally invasive lumbar decompression procedure usually have continued relief that can last up to five years.”
Steroid Injections for Spinal Stenosis
Dr. Young can reduce or eliminate inflammation and pain with a spinal stenosis treatment of steroid injections.
“An epidural injection is the most common approach,” he says. “Injecting steroids in those areas of the spine can lead to some relief.”
If there is an anatomical problem such as a bulging disc present, or overgrown joints in the back, advanced procedures are required.
“Injections are the first-line option for these things, and then when it comes to the next steps, we start to discuss the minimally invasive lumbar decompression procedure,” Dr. Young says.
“All of the injections that I typically perform are under image guidance. It helps me be quite precise in where those injections are delivered.”
What Are Interspinous Spacers?
“Interspinous spacers are a newer technology and offer an option for individuals who have spinal stenosis without evidence of ligamentum flavum thickening,” Dr. Young says.
“They can be implanted under twilight anesthesia, utilizing a tiny incision, followed by a short recovery phase of two weeks. After that time, patients are encouraged to return to their regular activities.”
The difference between spacers and the minimally invasive lumbar decompression procedure is that you’re propping open the spine, like a jack, to keep the space open. The spacers are made of titanium, and this spinal stenosis treatment itself is considered outpatient surgery.
“My patients will need to avoid bending at the waist, twisting at the waist, and lifting over 10 pounds for two weeks to allow the device to settle and scar into place,” Dr. Young says.
Who Does This Spinal Stenosis Treatment Work For?
This procedure helps patients who have to lean over to walk. “One thing I see as I watch older people is that they’re leaning forward; they may be using a walker or leaning over their shopping cart to lessen the pain of their spinal stenosis,” Dr. Young says.
With a small incision, a small device can be placed between the bones of the spine without altering the physical anatomy of the spine. The device is a custom fit for each patient. It has metallic wings that allow it to wedge itself into position and prevent the collapse of the spine, which leads to the pain associated with spinal stenosis.
“Based on the studies of this specific technique, patients who are feeling better at six months will still be doing well after two years,” Dr. Young says.
This spinal stenosis treatment is done in a surgical center on an outpatient basis.
Conditions to Be Met Before Interspinous Spacer Surgery
“Patients will need to have a bone density scan before the procedure to make sure the bones are strong enough to withstand any extra force or torsion from that device,” Dr. Young says.
“We also need to take special X-rays of your spine to show no shifting of the bones at that level. These are things that we can do right here in our office.”
How Long Does It Take for a Spinal Stenosis Treatment to Provide Relief?
Maximum relief is seen at six months,” Dr. Young says. “That isn’t to say that patients won’t experience relief earlier. Patients will improve their back and leg pain, and that benefit has been maintained for about two years. Beyond two years, we still have improvements in both the back and legs.”
“I know a lot of folks who have very realistic expectations because they’ve had pain for a long time. If you can reduce their pain by 70 percent, if you can make that big of a dent in their pain, it can greatly improve their quality of life.”
What Can Patients Expect During a Visit?
“When I first meet patients, I like to start from scratch,” Dr. Young says. “I meet with them in the office to discuss their symptoms: what hurts, when it hurts, and how it hurts. I like to know what they’ve tried, and I review any pertinent imaging. We can always get images in the office if they don’t have them. We review any tests they may have had in the past.”
What Happens After Diagnosis?
After diagnosis, Dr. Young gives patients a complete look at all the spinal stenosis treatment options available.
“I like to give patients a list of their options once I have a firm diagnosis of what’s going on,” Dr. Young says. “But they may come in with a pain complaint that is not clear, so there may be additional tests.”
“Once we have a working diagnosis, I like them to know they have options, from referral to a PT, prescription medications that work in various ways, and I’ll often suggest a minimally-invasive procedure, whether it’s an injection or something more advanced.”
How Do You Assess Pain Level?
“I think that one of the things I try to do is determine how much it’s interfering with their daily life,” Dr. Young says. “They’ll say, ‘I wish I could just get a good night’s sleep, but I’m always in pain’.”
“There are many different ways that patients can tell me what is being affected by their pain, and then we can look at how successful we can be to reduce the symptoms so they can walk and experience less pain and less fatigue.”
Schedule an Appointment With an IBJI Pain Management Physician
Looking for a spinal stenosis treatment to relieve your pain effectively? Schedule an appointment with one of our IBJI pain management physicians. Check with your insurance plan to see if you need a referral.
*Some of the content in this blog has been excerpted from Dr. Young’s webinar