Using Alternative Medicine to Manage Spinal Stenosis Pain

Alternative and holistic therapies generally are not thought of as treatments for spinal stenosis. The National Institute of Arthritis and Musculoskeletal and Skin Diseases (part of the NIH) says they are not considered to be a part of conventional medicine because more research is needed before definitive statements about their effectiveness can be made.

But more and more, doctors are recommending these treatments to their patients as adjuncts, and clinics are starting to offer them either as part of the treatment plan or as opportunities in their community education departments.

"Back pain is probably the most common reason why people seek out complementary and alternative medical treatments," says Rick Deyo, Professor of Evidenced-Based Family Medicine at the Department of Family Medicine, Oregon Health and Science University.  

Strategize Your Use of Alternative Medicine for Stenosis Related Back Pain

Spinal stenosis is an outcome of spinal arthritis, which means that maintaining your flexibility and joint range of motion is a key goal. Common sense dictates that choosing your holistic therapy with this goal in mind may help you manage, slow the progression of, or prevent spinal stenosis.

If you've tried traditional treatments for spinal stenosis but are left wanting more, or if you're simply curious about the possibility of taking a holistic approach, you're in the right place.

These alternative treatments that may fit well with your spinal stenosis management or prevention efforts.

1
Chiropractic Treatment

chiropractor treating female patient
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The goal of chiropractic treatment is to increase range of motion, and many people see a chiropractor to “loosen up their spine.” Traditionally, chiropractors are trained to do this using a grade 5 high-velocity manipulation, also known as an adjustment. Most people simply call this well-known technique “getting my back cracked.”

Regardless of terminology, the treatment is designed to restore the natural motion of your spine. But with advances in technology and the field of chiropractic, the profession now has more ways to accomplish the goal of a looser spine. Examples include, but are by no means limited to: traction, non-thrust techniques, offering massage and/or physical therapy services in their offices and more. 

Keep in mind that while many people are very passionate about their chiropractor, for acute back pain at least, the NIH SAYS research shows an adjustment is about as effective as any treatment you might get from your doctor or physical therapist. This includes the old standby “take 2 and call me in the morning,” and/or getting a prescription to physical therapy (and going, of course.)

Research

As far as spinal stenosis specifically goes, a 2009 review of studies published in the Journal of Chiropractic Medicine found only a few (6, to be exact) low-quality studies on the use of chiropractic. Four of the studies were case studies.

Although the studies suggested a positive benefit from using chiropractic for lumbar spinal stenosis, the low number combined with a lack of solid study design prohibited them from drawing a conclusion.

2
Massage Therapy

A smiling woman enjoys a massage.
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Massage therapy may help increase circulation to your soft tissues as well as release restrictions and muscle spasms that can keep you from moving fully. Plus it feels good! For these reasons, a massage every month or every week, as you are able to afford it, may make a good preventative adjunct to your regular exercise and stretching routines.  

If money is an issue, student clinics associated with massage schools in your area may offer reduced rates. This may be worth checking out. Another possibility is "community days," during which massage therapists offer lower rates once a month, quarter or year to help extend this treatment they so strongly believe in to those in need. And finally, many therapists offer sliding fee scales to clients.

Research

In a 2011 comparative effectiveness study that was published in the Annals of Internal Medicine, involving just over 400 people, Cherkin, et. al. found that massage therapy may make for an effective chronic back pain treatment. The researchers report that benefits for participants in their study lasted at least 6 months. The study also found that in terms of both symptom relief and disability relief, it didn't matter if you had relaxation type massage or a more structural massage. The results were comparable. 

A 2010 telephone survey published in the Journal of Back Musculoskeletal Rehabilitation and involving 75 patients and 76 physical therapists found that massage was the most frequently used therapy by patients, with 27% of the patients reporting getting massages as part of their treatment. It's interesting to note that the physical therapists interviewed in this study did not mention massage at all (though they did mention joint mobilization, which, similarly, is a hands-on treatment.)

Cautions

Because spinal stenosis is associated with arthritis, it's also associated with aging. Let's face it, as we age, we may become frailer. Although injury from massage is rare, it is possible. But if you come to a massage treatment with pre-existing health conditions, your risk for injury increases.  

For example, in 2013, Guo and associates described a case (published in the European Journal of Orthopedic Surgery & Traumatology) in which a 66-year-old man with osteoporosis sustained a vertebral fracture from a massage, and had to have surgery to repair it.

Think carefully about getting a massage if you have osteoporosis or osteopenia and check your massage therapist's credentials to be sure they have clinical experience with the kinds of health problems with which you deal.  And of course, ask your doctor about massage if you are at all unsure that it will be safe, given your existing health problems.

3
Feldenkrais

mature women in stretch class
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Feldenkrais is a movement re-education program accessible as a group class or as a one-on-one session with a certified practitioner. 

In a Feldenkrais session or class, the teacher/practitioner leads you through a series of micro-movements that, taken together, provide a focus on some aspect of your ability to move your body. For example, you may work on consciously experiencing the range of motion at your hip or the way in which the spine flexes and extends.  

Even though movement is involved, Feldenkrais is not a workout. It's more like a discovery session.

Although Feldenkrais is not directly aimed at increasing range of motion, many people report vastly increased flexibility, even after just one class. Note that if you already have a diagnosis of spinal stenosis, you should work with your doctor or physical therapist to determine if Feldenkrais would make a good therapy for you.

Some Feldenkrais practitioners are also licensed physical therapists and may be worth seeking out, again, if you've been diagnosed with this condition.

Sources

Deyo, R., MD, MPH. Dr. Rick Deyo discusses research for chronic low back pain. National Center for Complementary and Alternative Medicine, NIH. 

Spinal Manipulation for Low-Back Pain. NIH National Center for Complementary and Integrative Health website. 

Questions and Answers about Spinal Stenosis. Spinal Stenosis. NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases website.

Questions and Answers about Spinal Stenosis. Spinal Stenosis. NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases website. 

Stuber, K., et. al. Chiropractic treatment of lumbar spinal stenosis: a review of the literature. J Chiropr Med. 2009 Jun.

Cherkin DC, Sherman KJ, Kahn J, et al. A comparison of the effects of 2 types of massage and usual care on chronic low-back pain: a randomized, controlled trial. Annals of Internal Medicine. 2011; 155(1):1–9.

Guo, Z, et. al. Isolated unilateral vertebral pedicle fracture caused by a back massage in an elderly patient: a case report and literature review. Eur J Orthop Surg Traumatol. 2013. 

Tomkins, CC. et. al. Physical therapy treatment options for lumbar spinal stenosis. J. Back Musculoskeletal Rehabil. 2010.

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