Pain Management for Spinal Stenosis: Options for Patients

Pain Management for Spinal Stenosis: Options for Patients
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Spinal stenosis pain management is available for patients experiencing back and leg pain associated with this condition. The pain associated with spinal stenosis is caused by nerves being squeezed as the narrowing of the spinal canal gradually progresses. Regardless of what is causing a patient’s spinal stenosis, there are treatment options available to help relieve their pain.

Antidepressants

Certain antidepressants, referred to as tricyclic antidepressants may help to ease a patient’s pain when taken nightly. These medications help to maintain mental balance by increasing certain natural brain substances. It has been shown to be effective in relieving stabbing pains, burning pains, and chronic aches. The most commonly prescribed include nortriptyline and amitriptyline. Common side effects of nortriptyline and amitriptyline include:

  • Nausea
  • Drowsiness
  • Anxiety or excitement
  • Dry mouth
  • Constipation
  • Frequent urination
  • Sexual changes
  • Tiredness or weakness
  • Nightmares
  • Weight or appetite changes
  • Trouble urinating
  • Blurred vision
  • Excessive sweating

Amytriptyline can also cause:

  • Unsteadiness
  • Burning/tingling/pain in feet or hands
  • Confusion

Opioids

Opioids, also commonly referred to as narcotic pain medications, are a type of painkiller. They are prescribed for pain that is moderate to severe. As part of

pain management for spinal stenosis, hydrocodone (Vicodin) and oxycodone (Percocet and OxyContin) are the most commonly prescribed. These powerful painkillers attach to specific proteins located on the surface of cells within the gastrointestinal tract, spinal cord, and brain, called opioid receptors. They interfere with and stop pain messages from being transported to the brain. They also work within the brain to change how pain is perceived. They do not eliminate pain, but they do change how a patient perceives it. Common side effects of hydrocodone and oxycodone include:

  • Drowsiness
  • Nausea
  • Constipation
  • Vomiting
  • Dizziness
  • Nightmares
  • Hallucinations
  • Confusion
  • Trouble urinating
  • Depth of breathing decrease

Anti-Seizure Medications

Anti-seizure medications are mainly used to treat seizure disorders, but are more and more often being used to treat certain painful conditions, such as the pain associated with spinal stenosis. Since nerve damage is common with spinal stenosis and certain anti-seizure drugs have been proven effective in helping relieve some patient’s nerve pain, these medications are often used in a pain management regimen. Commonly prescribed anti-seizure medications for spinal stenosis include pregabalin (Lyrica) and gabapentin (Neurontin). These drugs can help to relieve nerve pain by calming the nerves and alleviating the stabbing, burning, and shooting pain that is typically caused by nerve damage. Common side effects of anti-seizure medications include:

  • Nausea
  • Double vision
  • Drowsiness
  • Liver damage
  • Vomiting
  • Loss of coordination
  • Headache

Resources

MayoClinic.com. (2010). Spinal Stenosis. Retrieved on August 20, 2010 from MayoClinic.com: https://www.mayoclinic.com/health/spinal-stenosis/DS00515

MedlinePlus. (2010). Spinal Stenosis. Retrieved on August 20, 2010 from MedlinePlus: https://www.nlm.nih.gov/medlineplus/ency/article/000441.htm

Image Credits

OxyContin: digpretzel – sxc.hu