Unless your workers comp spinal stenosis is causing significant problems or is rapidly getting worse, most doctors will begin with nonsurgical treatments. Up to one-half of all patients with mild-to-moderate lumbar spinal stenosis can manage their symptoms with conservative nonsurgical care.
At first, doctors may prescribe ways to immobilize the spine. Keeping the back still for a short time can calm inflammation and pain. This might include one to two days of bed rest. Positions which flex the spine forward, widen the spinal canal and can ease symptoms.
A lumbar support belt or corset may be prescribed, though their benefits are controversial. Lumbosacral corsets do not appear to offer any long-term benefits. The support provides symptom relief only while you are wearing it. The support can limit pressure in the discs and prevent extra movement in the spine. But it can also cause the back and abdominal muscles to weaken.
Doctors sometimes prescribe medication for patients with spinal stenosis. Patients may be prescribed anti-inflammatory medication such as nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin.
Narcotic drugs, such as codeine or morphine, are generally not prescribed for stenosis patients. They are addictive when used too much or improperly. Muscle relaxants are occasionally used to calm muscles in spasm.
Symptoms of workers comp spinal stenosis can lead to mood changes. As a result, doctors sometimes prescribe anti-depressant medication, called tricyclics. Tricyclics help steady peoples’ moods, and some tricyclics even improve sleep by helping the body make an important hormone called serotonin.
Some patients are given an epidural steroid injection (ESI). The spinal cord is covered by the dura. The space between the dura and the spinal column is called the epidural space. It is thought that injecting steroid medication into this space fights inflammation around the nerves, the discs, and the facet joints. This can reduce swelling and give the nerves more room inside the spinal canal. Research shows that a single steroid injection offers only short-term relief. Multiple injections can produce long-term, lasting pain relief.
Patients often work with a physical therapist. By evaluation, your therapist can assign positions and exercises to ease your symptoms. Your therapist may suggest using traction. Traction is a common treatment for stenosis. It gently stretches the low back, taking pressure off the spinal nerves. Your therapist may also suggest strengthening and aerobic exercises. Strengthening exercises focus on improving the strength and control of the back and abdominal muscles. Aerobic exercises are used to improve heart and lung health and increase endurance in the spinal muscles. Stationary biking offers a good aerobic treatment and keeps the spine bent slightly forward, a position affording relief to many patients with lumbar stenosis.
McCormick Law Office in Milwaukee, Wisconsin.
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