Lumbar Spinal Stenosis is a narrowing of the space between vertebrae where the spinal cord and the spinal nerves travel.
It is a diagnostic term to describe lower back pain with or without weakness and loss of sensation in the legs. It is a very common condition brought on mostly by aging and the accompanying degeneration of the spine.
As we age, discs compress, muscles, ligaments, and tendons weaken. With the spine weakened, the boney structures of the vertebrae begin to overgrow (osteoarthritis) as a means to stabilize the structure. The new boney mass begins to encroach on the openings in the spine that the nerves and spinal canal pass through. As the openings begin to narrow, the spinal canal and nerves rub against the bone causing irritation, inflammation and the symptoms of stenosis mentioned above.
Many patients come into our office with a date for surgery or, and more unfortunate, a diagnosis of failed back surgery. For the patients who had put off surgery, they have explored their options and have discovered that surgery is not the answer for them. For the patients who had the surgery, they need more options than before.
In the recommended surgical procedures for spinal stenosis, two choices are the most favored. A Decompression procedure where the surgeon will shave and cut away the bone narrowing the spainal canals. The second, a fusion procedure to limit the movement between two vertebrae and hopefully stop the compression of nerves.
Surgery for spinal stenosis should always be considered only after other conservative therapies have been exhausted because it is usually not as successful as hoped and leads to a new diagnosis “failed back surgery syndrome,” where symptoms continue to deterioriate. It is important to note that in instances where stenosis is so severe that the patient has lost circulation to the legs or bladder control – a surgical consult should be made immediately.
Many “conservative” or non-surgical treatment options include the use of anti-inflammatories or epidural cortisone injections. We avoid the use of these treatments as they are temporary “quick-fixes.” The medical literature is now long in studies that have shown that these treatments are contributors to accelerated deterioration of spinal and joint degeneration.
Osteoarthritis occurs because the bone is trying to stabilize a joint. Fusion surgery is recommended as a means to accelerate that type of stabilization – the use of bone for stabilization. Prolotherapy works a completely different way. It stabilizes by strengthening the often forgotten and under appreciated spinal ligaments and tendons.
Treatment without Anti-Inflammatory Medications or Painkillers
It has been estimated that 70% of lower back pain can be traced to problems of the ligaments. Why then aren’t most therapies geared to treating the ligaments? Because many physicians do not believe that the ligaments can be successfully treated. Why? Because ligaments have very poor circulation and therefore do not have the ability to heal. This is taught in basic anatomy. Muscles are big, red, and powerful because they are filled with blood. Ligaments and tendons are small and white because there is no blood in them.
For more information please see our article on Opioid medications for chronic pain.
Prolotherapy for lumbar spinal stenosis
Research over the last 60 years – has shown that Prolotherapy, the introduction of an irritant solution into the spine through injection, strengthens ligaments and tendons and stabilizes the spine by accelerating the body’s natural healing response – regrowth of tissue through control and rapid inflammation.
In one study, one hundred and ninety (190) patients were treated during a seven year study period. The outcomes suggests that prolotherapy using a variety of proliferants can be an effective treatment for low back pain from ligament problems when performed by a skilled practitioner. 1
1. Watson JD, Shay BL. Treatment of chronic low-back pain: a 1-year or greater follow-up. J Altern Complement Med. 2010 Sep;16(9):951-8. doi: 10.1089/acm.2009.0719.