What helps spinal stenosis besides surgery?

@kaptainkat Thank you for your comments. One question I asked my spine surgeon was what would happen if I don't have decompression surgery? That is important to know what might be lost. I saw my parents difficulty as they were disabled in wheel chairs, and if I had a choice, I didn't want that for myself. I wanted quality of life even though, a compromise is made when having surgery.

The recovery and results of a spine procedure depends on many things. First, not all surgeons are gifted, and it is worth shopping around until you find one who excels in their abilities of their job and who loves their job. That might be harder than it sounds, and it may be worth asking a trusted doctor for a recommendation. The surgeon who operated on me was at Mayo in Rochester.

Some people have multiple levels of spine injury or disease, some have congenital malformations, and some have minimal issues such as myself in having one damaged disc from an injury. Some people are in better shape and have better posture, all of which affects how well the spine is supported which can reduce wear and tear.

The health and fitness of the patient is also very important. Smokers do not heal as well from spine surgery in general, and many surgeons will make them quit smoking before doing a procedure. In general, they have lower levels of oxygen available to the body. Diet is important too because the body needs protein to heal bone that begins before minerals are deposited to harden it. Age is a factor, but aging is also influenced by habits good or bad. If you are eating a healthy balanced diet that reduces systemic inflammation, essentially you are "younger" than someone who eats all the wrong things. What most of us think of as "aging" are health changes because of inflammation.

I am an advocate for always asking questions to be well informed for an important decision such as surgery. Spine surgery has come a long way and is better today than it was 20 years ago. I was loosing the ability to control my arms, and I am an artist, so regaining what I was loosing was very important to me. I didn't find a surgeon willing to help me until I came to Mayo because my case was a bit unusual and confusing. Surgeons have to be very careful not to mistake pain for something else like MS, so it is easy for them to back out if they think a patient will have a poor outcome or they don't understand the source of the pain.

This is my story.
https://newsnetwork.mayoclinic.org/discussion/using-the-art-of-medicine-to-overcome-fear-of-surgery/

Hello, Jennifer I too am currently going through the loss of my arms/Hands. End of January I am heading back to Mayo in Rochester for my 3rd visit for my C-Spine that has Progressed Worse. I have Tried every PT, Accupuncture, And Massage, Chiropractic, Dry Needling, faithfully do my at home stretches learned from therapy. Recently in Oct 2023 I was @ Work lost feeling in arms/ legs and my Head was pounding, I can't sleep w/ a pillow or even stay asleep due to the Excruciating Pain, of razors, pins, needles in my neck, down my arms and hands. I really wanted to reach out to find a Good Surgeon, even though I'm seeing My Neurosurgeon at Mayo end of this month, I feel he just keeps wanting to put a Minimal Band-Aide on my Neck, such as Injections, which never work. Or medication which I deny, cuz I'm one that doesn't take Pills. I feel he wants me to wait till it's later when it's worse, My MRi, shows that it has greatly Progressed Worse C-4,5 and 6, 7 and I can't deal with this pain and been off work since October and at home, I can't even do my daily house cleaning or lift, bend, sit, or sleep. Any recommendations on your behalf of a Surgeon At Mayo, that Actually listens, and get this pain/Neck issue resolved.. This has been ongoing since 2014, and as I aged its severe now. Thank you.
Susan

Hello, Jennifer I too am currently going through the loss of my arms/Hands. End of January I am heading back to Mayo in Rochester for my 3rd visit for my C-Spine that has Progressed Worse. I have Tried every PT, Accupuncture, And Massage, Chiropractic, Dry Needling, faithfully do my at home stretches learned from therapy. Recently in Oct 2023 I was @ Work lost feeling in arms/ legs and my Head was pounding, I can't sleep w/ a pillow or even stay asleep due to the Excruciating Pain, of razors, pins, needles in my neck, down my arms and hands. I really wanted to reach out to find a Good Surgeon, even though I'm seeing My Neurosurgeon at Mayo end of this month, I feel he just keeps wanting to put a Minimal Band-Aide on my Neck, such as Injections, which never work. Or medication which I deny, cuz I'm one that doesn't take Pills. I feel he wants me to wait till it's later when it's worse, My MRi, shows that it has greatly Progressed Worse C-4,5 and 6, 7 and I can't deal with this pain and been off work since October and at home, I can't even do my daily house cleaning or lift, bend, sit, or sleep. Any recommendations on your behalf of a Surgeon At Mayo, that Actually listens, and get this pain/Neck issue resolved.. This has been ongoing since 2014, and as I aged its severe now. Thank you.
Susan

@wil24 Hi Susan. Thank you for reaching out. It is actually a good thing that you are not being rushed into surgery. Perhaps your surgeon wanted to exhaust all options first before proceeding to surgery. I'm guessing that your follow up at Mayo will be with this new MRI and to discuss the findings and changes since the prior imaging?

When I came to Mayo and saw Dr. Fogelson, I had been dismissed by 5 locals surgeons who just didn't understand how my symptoms were related to my imaging. I spent 2 years trying to get help locally and worrying about having permanent damage and they wouldn't offer to help. I also would not want a surgeon guessing if they didn't understand the problem. Sometimes, you just need to get several opinions before finding the right surgeon with a good plan of care. This is my surgeon at Mayo, and he is excellent at his techniques and at helping patients feel at ease.
https://www.mayoclinic.org/biographies/fogelson-jeremy-l-m-d/bio-20055624
You don't have to agree to do spine injections or take pain medications. Those are your choices as a patient, and it may be that your insurance company wants to see this as justification that surgery is necessary. When PT fails to improve your condition, it also says that surgery may be needed. I know it is frustrating. Problems with legs do happen with cervical spine issues with spinal cord compression. There may also be lumbar spine issues contributing to leg pain, but in my case, there was not a lumbar issue, and leg pain was generated only by the cervical area due to stenosis in the central canal. That was the symptom I had that confused so many surgeons before I got to Mayo. That is called "funicular" or referred pain.

What you can do to make the most of your appointment is to write a list of questions that you have. The motto at Mayo is "the needs of the patient come first", so your surgeon should listen to your concerns. Make sure you ask direct questions because they don't know what you are thinking unless you tell them. It is always worth asking how your condition will progress without surgery and how fast, and if and when permanent damage occurs. That may be very hard to answer. If your surgeon knows that you want to fix this with surgery and will follow advice, they may be more willing to listen. Every case is different and the surgeon has to qualify you for a procedure and consider other diagnoses that could be confused with spine symptoms to make sure to cover all the possibilities.

When you have spinal fusions, it usually increases the chances of the levels adjacent to the fusion developing damage from the increased stress on them, so that may be a reason the surgeon is waiting. Adjacent segment problems do also happen after artificial disc replacements, and to patients who have not had any spine surgeries. It may be that the risks are a bit higher with fusions. There is a right time to do surgery, and after that, you do your best to maintain what you have, and not increase chances of future problems.

Would you share your experience after your follow up at Mayo?

@wil24 Hi Susan. Thank you for reaching out. It is actually a good thing that you are not being rushed into surgery. Perhaps your surgeon wanted to exhaust all options first before proceeding to surgery. I'm guessing that your follow up at Mayo will be with this new MRI and to discuss the findings and changes since the prior imaging?

When I came to Mayo and saw Dr. Fogelson, I had been dismissed by 5 locals surgeons who just didn't understand how my symptoms were related to my imaging. I spent 2 years trying to get help locally and worrying about having permanent damage and they wouldn't offer to help. I also would not want a surgeon guessing if they didn't understand the problem. Sometimes, you just need to get several opinions before finding the right surgeon with a good plan of care. This is my surgeon at Mayo, and he is excellent at his techniques and at helping patients feel at ease.
https://www.mayoclinic.org/biographies/fogelson-jeremy-l-m-d/bio-20055624
You don't have to agree to do spine injections or take pain medications. Those are your choices as a patient, and it may be that your insurance company wants to see this as justification that surgery is necessary. When PT fails to improve your condition, it also says that surgery may be needed. I know it is frustrating. Problems with legs do happen with cervical spine issues with spinal cord compression. There may also be lumbar spine issues contributing to leg pain, but in my case, there was not a lumbar issue, and leg pain was generated only by the cervical area due to stenosis in the central canal. That was the symptom I had that confused so many surgeons before I got to Mayo. That is called "funicular" or referred pain.

What you can do to make the most of your appointment is to write a list of questions that you have. The motto at Mayo is "the needs of the patient come first", so your surgeon should listen to your concerns. Make sure you ask direct questions because they don't know what you are thinking unless you tell them. It is always worth asking how your condition will progress without surgery and how fast, and if and when permanent damage occurs. That may be very hard to answer. If your surgeon knows that you want to fix this with surgery and will follow advice, they may be more willing to listen. Every case is different and the surgeon has to qualify you for a procedure and consider other diagnoses that could be confused with spine symptoms to make sure to cover all the possibilities.

When you have spinal fusions, it usually increases the chances of the levels adjacent to the fusion developing damage from the increased stress on them, so that may be a reason the surgeon is waiting. Adjacent segment problems do also happen after artificial disc replacements, and to patients who have not had any spine surgeries. It may be that the risks are a bit higher with fusions. There is a right time to do surgery, and after that, you do your best to maintain what you have, and not increase chances of future problems.

Would you share your experience after your follow up at Mayo?

In reply to @wil24…. Although I have very high regard for Mayo (Rochester) as I see a number of specialists there, I went for that 2nd opinion regarding L4-5 after working with the specialist at Mayo for 2 years. I did all the conservative treatments, but when he suggested radio frequency ablation-I asked what its purpose was and the answer did not address anything but perhaps a lessening of pain, but not the issue of my collapsed disc. I found an excellent spine surgeon at a different location: attempted a spinal injection (no improvement); and then proceeded to surgery. I had a decompression, fusion of the L4-5. It was an excellent choice for me and I followed all post operation restrictions for a long time. I feel very good and no longer suffer daily, unmanageable pain. I do not know what the future holds, but today is very good. Thought you’d might like to hear a story of success when finding a positive other opinion that works. Good luck with whatever direction you choose as there are no guarantees.💕