Best Meds For Spinal Stenosis

Question

Asked by Rhonda

Best Meds For Spinal Stenosis

My 74 yr. old mother was diagnosed with spinal stenosis this past summer. The orthopedist tried the epidural shots in her back. She had some relief for about a week, and the pain returned. She's currently been going to a chiropractor and getting some relief from her pain. Her family doctor has her on Diclofenac (Voltaren), but it seems to be wearing out on her. What are some of the better pain relievers for spinal stenosis? She has aortic stenosis as well so the doctors are a little reluctant to operate on her back if they absolutely do not have to. They would rather just try to manage the pain with pain relievers. Is there something stronger than Diclofenac that she could take that wouldn't cause terrible side effects or extreme drowsiness? All she wants to be able to do is walk or stand comfortably. She knows that nothing can be done about the disc degeneration (except surgery) but at this point we're only interested in keeping her comfortable and getting the pain under control. Any suggestions?

Answer

When comfort care is the best option for the elderly, medications can help to make life a little easier. Of course the elderly are very sensitive to medication side effects like drowsiness and dizziness. Within the families of medications like anti-convulsants and opioids, there do exist viable options for even the most sensitive. The key is to start low and go slow when trying a new medication. An anti-convulsant can be used to treat the nerve pain of spinal stenosis. The best choice is Zonegran because it has the least amount of side effects. Opioid pain medications are best used on an as needed basis for the occassional pain of spinal stenosis (assuming that your mother, like most with spinal stenosis, is comfortable while sitting). The best opioid for the elderly is hydromophone (dilaudid). It comes in low 2mg tablets as can be used prior to an activity like Christmas shopping. Plain old Tylenol can also be a good alternative. A neurologist, rehabilitation, or pain specialist should be able to assist you in finding the best option for your mom.

Dr. Christina Lasich, MD

Answered by Christina Lasich, MD