This Health Alert is intended for readers interested in learning about the prevention, diagnosis, and management of back pain.
Spinal stenosis – a narrowing of the spinal canal – affects many people in their 50s and 60s and can cause severe pain in the back, buttocks, thighs, and calves. Recently, a reader asked: I've had back pain from lumbar spinal stenosis for nearly six months. Should I consider surgery or just continue with conservative treatment even though it doesn't seem to be helping? Here’s our advice.
You might want to consider surgery for your spinal stenosis, since you've had no relief from conservative treatment. In fact, a recent study in The New England Journal of Medicine found that surgery to decompress the spinal nerves is likely to be the better solution to relieve the pain of spinal stenosis in someone who has had symptoms for at least three months.
This analysis, from the landmark Spine Patient Outcomes Research Trial (SPORT), included 654 people who were candidates for surgery and had symptoms from spinal stenosis without degenerative spondylolisthesis for at least three months. Ultimately, 400 of the people had surgery for spinal stenosis. After two years, twice as many people who had surgery said they had a major improvement in their back condition compared with those who had nonsurgical care, which consisted of physical therapy, a home exercise program, and nonsteroidal anti-inflammatory drugs to ease pain. In addition, more of those who had surgery said they felt less pain and their ability to function improved.
Nonsurgical treatments can lead to modest improvements in symptoms caused by lumbar spinal stenosis, and it's likely your symptoms won't get worse if you decide not to have surgery. But to relieve your pain, surgery for spinal stenosis appears to be a better choice.
