Symptom Finder - Treatment of Lumbar Spondylosis
LUMBAR SPONDYLOSIS
1. Initial treatment involves the use of NSAIDs such as, naproxen(Naprosyn) 500 mg bid–tid. Other NSAIDs may be tried
2. If the above is unsuccessful, add a muscle relaxant such as, cyclobenzaprine (Flexeril) 5–10 mg tid. Other muscle relaxants may be tried
3. If the above combination is ineffective try alternate day prednisone 10–30 mg. Continue this therapy for 4–6 weeks or until definite improvement is noted. This schedule of corticosteroids rarely results in systemic complications.
4. At the same time the patient is receiving anti-inflammatory drugs and muscle relaxants begin an exercise program including pelvic tilts, sit-ups, and knee bends. If necessary enlist the help of a physiotherapist to school the patient on these exercises.
5. In persistent cases, refer the patient to a physiotherapist for evaluation and treatment.
6. For obese patients a reducing diet is prescribed along with an appetite suppressant if necessary.
7. A firm mattress or bed board should be prescribed.
8. Intractable cases may benefit from epidural steroid injections. These patients should also be given the benefit of evaluation by on orthopedic or neurologic surgeon.
9. Avoid narcotic analgesics unless the patient has a consult with a pain management specialist.
10. Never give up hope for these patients until they have had the benefit of a psychiatric consult or psychometric testing.
1. Initial treatment involves the use of NSAIDs such as, naproxen(Naprosyn) 500 mg bid–tid. Other NSAIDs may be tried
2. If the above is unsuccessful, add a muscle relaxant such as, cyclobenzaprine (Flexeril) 5–10 mg tid. Other muscle relaxants may be tried
3. If the above combination is ineffective try alternate day prednisone 10–30 mg. Continue this therapy for 4–6 weeks or until definite improvement is noted. This schedule of corticosteroids rarely results in systemic complications.
4. At the same time the patient is receiving anti-inflammatory drugs and muscle relaxants begin an exercise program including pelvic tilts, sit-ups, and knee bends. If necessary enlist the help of a physiotherapist to school the patient on these exercises.
5. In persistent cases, refer the patient to a physiotherapist for evaluation and treatment.
6. For obese patients a reducing diet is prescribed along with an appetite suppressant if necessary.
7. A firm mattress or bed board should be prescribed.
8. Intractable cases may benefit from epidural steroid injections. These patients should also be given the benefit of evaluation by on orthopedic or neurologic surgeon.
9. Avoid narcotic analgesics unless the patient has a consult with a pain management specialist.
10. Never give up hope for these patients until they have had the benefit of a psychiatric consult or psychometric testing.
