Anti-inflammatories and analgesics (pain relievers) are used first. Physical therapy to help with pain, improve motion, and function may be helpful. Some patients are good candidates for epidural steroid injections.
Many patients try other alternative forms of treatment such as chiropractic, osteopathy, acupuncture, massage, and so on. Sometimes the pain can be decreased enough to improve walking and daily activities of living.
When nothing else helps, surgery may be considered. There are several different procedures that can be used. Decompression and spinal fusion are the two most common operations. The surgeon may or may not use posterior instrumentation.
Instrumentation refers to the use of metal plates, screws, rods, or wires to hold the bones in position. Posterior just means the surgeon performs the operation from the back rather than from the front of the body.
Studies have not been able to pinpoint the best treatment for this condition. Surgery seems to help patients the most who have severe, disabling pain. But which operation should be used is still based on the surgeon's preference rather than solid evidence of which operation is best for each patient.
Complications are common and older patients may not tolerate those well.