Multidisciplinary Care Helps Relieve Spinal Stenosis Pain

Spinal stenosis is a degenerative spine condition caused by narrowing of the lumbar spinal canal. This painful disease can make it difficult for people to maintain an active lifestyle.

To get back to feeling like themselves, people who have spinal stenosis need the kind of multidisciplinary care available through the Advanced Spine Center, a program available at Lehigh Valley Health Network (LVHN).

“Lumbar stenosis is seen in approximately 20 to 25 percent of the population,” says Daniel Cataldo, DO, orthopedic spine surgeon at Lehigh Valley Orthopedic Institute. “However, the average age of presentation is 65 years old. It is slightly more common in males and in patients with increased BMIs.”

Classic symptoms include low back and lower extremity pain. Discomfort worsens with prolonged standing and walking. There may also be pain in the neck, or pain, numbness or weakness in the arms or legs. Degenerative spine changes, herniated disks and other problems can cause the condition. 

“Doctors or clinicians should refer patients with back pain to LVHN if they have bothersome symptoms for greater than two weeks that have not responded to conservative care, including rest, over-the-counter pain medication or physical therapy,” says Ricardo Georges, MD, pain medicine specialist with Lehigh Valley Orthopedic Institute.

According to Dr. Cataldo, a doctor or clinician may diagnose a person with spinal stenosis after reviewing their history, conducting a physical exam and examining MRI results for lumbar stenosis. 

Care usually begins with conservative management, according to Kerry Cerana, MD, a physiatrist at Lehigh Valley Orthopedic Institute. This may include physical therapy, chiropractic medicine, nonopioid prescription medication and lifestyle modifications.

“If symptoms continue despite these treatments, or if symptoms are severe, we may offer epidural steroid injections to decrease inflammation,” Dr. Cerana says.

Nonsurgical options significantly alleviate symptoms in the majority of patients, according to Dr. Cataldo. “However, if these options fail to provide patients with significant or long-standing relief of their symptoms, then surgical interventions are also available,” he says.

Surgical procedures range from minimally invasive decompressive laminectomies to lumbar fusions. “While all surgeries have a certain level of intrinsic risk, as clinicians, it is our responsibility to reassure patients and dispel the historical hesitation about spine surgery,”

Dr. Cataldo says, noting that advancements in surgical techniques and other areas have made spine surgery highly successful in improving a person’s quality of life.