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How is lumbar spinal stenosis treated?

Jun 21, 2021 Source: Cainiu Health
Dr. Lin Yunfei
Introduction
1. General Treatment: Patients with severe pain should rest in bed to alleviate symptoms. 2. Pharmacological Treatment: For aseptic inflammation of the nerve root, analgesic and anti-inflammatory medications (e.g., Fenbid®) may be used. 3. Manual Therapy: The objectives of manual therapy include promoting blood circulation, relaxing muscles and tendons, dispersing stasis, and releasing adhesions to relieve symptoms. Commonly employed techniques include kneading, grasping, rubbing, and friction.

Lumbar spinal stenosis refers to narrowing of the lumbar spinal canal, neural foramina, and intervertebral foramina—regardless of cause—as well as reductions in spinal canal volume due to soft-tissue changes or intrinsic narrowing of the dural sac, all of which may lead to low back and leg pain along with a constellation of neurological symptoms. This condition is termed “lumbar spinal stenosis syndrome.” So, how is lumbar spinal stenosis treated? The following addresses this question.

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How Is Lumbar Spinal Stenosis Treated?

1. Conservative Management

Patients with severe pain should rest in bed to alleviate symptoms. Once symptoms improve, they should wear a lumbar support brace when ambulating and perform appropriate lumbar and paraspinal muscle strengthening exercises to enhance metabolism and consolidate therapeutic effects. Additionally, maintaining proper body mechanics during physical labor and cultivating healthy lifestyle habits are essential. When lifting heavy objects, individuals should flex their hips and knees while keeping the back straight, hold the object close to the body, and then exert force to rise and step forward. Prolonged sitting, standing, or working at a desk should also be avoided.

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2. Pharmacological Treatment

For aseptic inflammation of the nerve roots, analgesic and anti-inflammatory medications (e.g., ibuprofen) may be used. Traditional Chinese medicine (TCM) approaches focus on warming and unblocking the meridians and strengthening tendons and bones. A commonly prescribed formula is Bu Shen Zhuang Jin Tang (“Kidney-Tonifying and Tendon-Strengthening Decoction”), modified according to individual needs—for example, with prepared rehmannia (Shu Di Huang), baked ginger (Pao Jiang), eucommia bark (Du Zhong), achyranthes root (Niu Xi), processed cibotium rhizome (Zhi Gou Ji), and dipsacus root (Xu Duan). For patients presenting with qi deficiency and blood insufficiency, astragalus (Huang Qi), codonopsis (Dang Shen), angelica root (Dang Gui), and white peony root (Bai Shao) may be added. For those experiencing cold-type low back and leg pain, chicken-blood vine (Ji Xue Teng), pubescent angelica root (Du Huo), cinnamon twig (Gui Zhi), and epimedium (Yin Yang Huo) may be incorporated. However, all TCM prescriptions must be administered under the guidance of a qualified TCM practitioner.

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3. Manual Therapy

The goals of manual therapy include promoting blood circulation, relaxing muscles and tendons, dispersing stasis, and releasing adhesions to relieve symptoms. Commonly employed techniques include kneading, grasping, rubbing, friction, and passive flexion–extension movements of the lower limbs. Epidural steroid injections may also be used to reduce swelling, release adhesions, and alleviate symptoms. Furthermore, targeted strengthening exercises for the erector spinae and abdominal muscles can enhance lumbar stability and thereby slow the progression of degenerative changes in the lumbar spine.

The above outlines the main treatment approaches for lumbar spinal stenosis. We hope this information is helpful to you.

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