Question
I have been diagnosed (via Cat scan) with spinal stenosis at L4. My family MD has not discussed this much with me despite the pain. His assistant thinks there's not much that can be done. When I brought the subject up again w. my MD, he said he could refer me to an orthopedic surgeon for possible injections or surgery.

I have tried both chiropractic therapy and acupuncture--both gave no relief.

Is there any nonsurgical treatment available? I'm not incapacitated yet and I sleep well. But my urologist suggested that the condition may advance to where I'll be living on narcotics.  My age is 64 and I'm Caucasian male.

Answer
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Hello P.,

I admire your persistence to find a non-surgical treatment option.  I'm sorry to hear your acupuncture and chiropractic treatments did not help enough.  As a side note, I would recommend trying a couple different chiropractors and acupuncturists, because these hands-on practices can vary significantly from practitioner to practitioner, and you may respond better with someone else.  You may want to look for a FACO or DACBO chiropractor.  These chiropractors have additional training and specialization in orthopedics, so they may be more suitable for your condition.  You should know after a few treatments whether or not it will be beneficial for you to continue care with your new practitioner based on how different or similar they are to your prior practitioners and how you feel after a few treatments.

Keep in mind, I haven't seen any of your X-rays/CT scans, so my advice might be different if I saw something unique to your situation.  Because of that, my recommendations may not be perfectly tailored to help you.  However, a non-surgical procedure that has helped a vast number of patients with low-back pain is the DRX-9000 spinal decompression machine.  These are very expensive machines and treatment can cost you $200-$300 per session.  The problem is that these machines typically work for general low-back pain and bulging discs -- not necessarily spinal stenosis.  You may find that it doesn't help you much.  In fact, depending on the severity of your condition, it may even aggravate your back.  That's why it's important to have a thorough evaluation by the practitioner who uses this machine in his/her office before you undergo this treatment.  If you did try this treatment, you should know after a few treatment sessions if it's going to help or not so that you don't have to spend a fortune only to find it not improve your symptoms.  You can find a provider with the DRX-9000 in your area by searching for the machine on the Internet and your location.

Another option is to ask your orthopedist for a referral to physical therapy.  Also ask your doctor how much you think the PT will be able to help your back.

Yoga also helps a lot of people with degenerative stenosis, but this is all dependent on the severity of your condition.  It can also take a very long time before you start to feel better, with no guarantee or way of knowing how much better (or worse) you will feel down the road.  In fact, it may do nothing to help you.  (This is the part of healthcare that is like looking into a crystal ball.  There is rarely a guarantee one treatment will definitely work since not all patients are alike and they all respond differently to different treatments).

There are a variety of causes for spinal stenosis, and not all causes are treated the same way.  So the most important thing you should do is if you're going to try to manage your back without surgery or medications, get evaluated and treated by a knowledgeable doctor, such as a chiropractic orthopedist, who has more training and knowledge about how to handle more complicated conditions, such as yours.  Other than that, spinal stenosis is very tricky handling naturally.

I hope you find this information a bit helpful and things work out for you.  Best of luck!

Dr. J.R. Strecker, D.C.