- Physical therapy
- Aerobic exercise
- Pain meds
- Epidural steroid injection
Sciatica and StenosisSciatica can be caused by stenosis. This is when the spinal canal narrows, constricting, and pinching the nerves specifically the sciatic. Around ninety percent of cases stem from a herniated disc compressing the nerve roots. The damaged disc extends out and pinches the roots of the sciatic nerve. This pinching causes:
- Muscle weakness
Lumbar Stenosis Surgery Options
- Lumbar stenosis surgery depends on the cause of sciatica: A single herniated disc could be pressing the nerve, which would only require the removal of just that portion of the disc that’s causing the compression. This procedure is known as a discectomy or microdiscectomy.
- If the stenosis is caused by a bone problem like an arthritic bone spur, then space has to be made in the canal. This means a portion of the lamina or the back of the spinal column. This is called a hemilaminectomy. Sometimes the whole lamina has to be removed. This is known as a laminectomy.
- If there is the instability of the spinal column, some of the lumbar vertebrae will be fused together to prevent further instability and added nerve compression.
Surgical SuccessIf the non-surgical options yielded minimal positive results or completely failed and surgery is the last resort talk with your surgeon to discuss the risks and benefits. The discussion will focus on factors like:
- Health status – levels of wellness and illness
- Underlying conditions
- Type of work
- Depression: this was because there were patients that continued to have sciatica symptoms after surgery. This means they are more likely to take antidepressants or anticonvulsants.
- Quality of life from health perspective was low.
- Previous spine surgery
OptimizationSurgical success depends on making sure patients are optimized before surgery. Increasing the chances of successful surgery after conservative treatment/s a surgeon will ask the patient to take these steps:
- Weight loss is difficult, but it has been shown to improve surgical outcomes.
- A healthy but sensible diet with a moderate calorie deficit is essential.
- Light aerobic exercise, such as stationary or recumbent cycling can help keep the body’s blood flowing properly.
- Exercising with pain is difficult but it will increase the cardiovascular system along with keeping the heart and lungs healthy enough to undergo surgical stress.
- If the exercising causes too much pain ask the doctor about anti-inflammatory, muscle relaxants, or steroid medication along with the non-surgical treatment that can provide relief allowing exercise to resume.