Spinal stenosis is a chronic condition that cannot be “cured,” although it often be improved and maintained over the long term. Patients can work with a doctor of chiropractic, to reduce symptoms and improve their quality of life.
Signs and Symptoms of Stenosis:
- Pain triggered by walking or prolonged standing, which is usually improved by sitting in a forward-leaning flexed position
- Numbness, tingling, and hot or cold feelings in the legs
- Muscle weakness and spasms
Older adults often are hunched over or walking with a cane or walker due to this pain, which is described as tingling or numbness in the lower back, buttocks, and legs.
Recently, researchers analyzed the effects of Pregabalin on the leg symptoms of 29 spinal stenosis patients and found no differences in the time it took to experience moderate pain by walking on the treadmill whether receiving a placebo or Pregabalin.
“Chronic low back pain is one of the most common reasons why older adults go to the doctor and lumbar stenosis is the leading indication for surgery in this age group … while physicians have increasingly looked for medication alternatives to opioid pain medication like gabapentin and pregabalin to help these patients manage their pain, until now there has been no credible evidence as to whether or not these treatments are effective for this problem.”
Pregabalin (Lyrica) is an anti-seizure medication, often used as a chronic pain treatment for shingles, spinal cord injury, fibromyalgia, and diabetic peripheral neuropathy, but is also used as an off-label treatment for chronic low back pain syndromes like lumbar spinal stenosis.
“Given the cost and potential side effects associated with pregabalin, it is critical that we understand the efficacy of this drug,” Markman continued. “This study convincingly demonstrates a lack of relief with pregabalin for the walking pain associated with lumbar spinal stenosis.”
In addition, Pregabalin (Lyrica) taken for a long time, will deplete Vitamin B1 and Vitamin D. Chronic Vitamin B1 depletion can cause pricking and burning sensation in the toes and feet, leg cramps and atrophy or wasting of the muscles and difficulty walking – some of the same symptoms the drug is initially being prescribed for!
Chronic lack of Vitamin D may also have a role in neurological disorders (movement disorders, lack of self-sufficiency) and worsening functional status due to muscle weakness, instability and falls.
Preliminary studies of chiropractic care for lumbar stenosis have all demonstrated positive results.
Surgery may not have a better outcome for stenosis than conservative care like chiropractic. A study of more than 650 spinal stenosis patients who had surgery or received nonsurgical treatment showed that for the first several years, patients who had surgery had better outcomes. However, after eight years of follow-up, there were no significant differences between the two groups in terms of pain, functioning or disability, according to the study in the January 15, 2014, issue of the journal Spine. Furthermore, of the patients who had surgery, 18 percent had repeat surgery for recurrent spinal stenosis within eight years, said study leader Dr. Jon Lurie and colleagues in a journal news release. The study authors are from Dartmouth-Hitchcock Medical Center in Lebanon, N.H.
Neurology. 2015 Jan 20;84(3):265-72. doi: 10.1212/WNL.0000000000001168. Epub 2014 Dec 10. Double-blind, randomized, controlled, crossover trial of pregabalin for neurogenic claudication. Markman JD1, Frazer ME2, Rast SA2, McDermott MP2, Gewandter JS2, Chowdhry AK2, Czerniecka K2, Pilcher WH2, Simon LS2, Dworkin RH2. J Chiropractic Med. 2009 Jun; 8(2): 77–85. doi: 10.1016/j.jcm.2009.02.001 PMCID: PMC2780929 Chiropractic treatment of lumbar spinal stenosis: a review of the literature Kent Stuber,a, Sandy Sajko,b and Kevyn Kristmansonc Vnitr Lek. 2012 May;58(5):393-5. [Vitamin D and neurological diseases]. [Article in Czech] Polívka J1, Polívka J Jr, Peterka M, Rohan V, Sevčík P, Topolčan O.