Spinal Stenosis

Q I am a 69-year-old woman. The hospital mentioned surgery, but I am putting it off because I am scared. Is it realistically possible to avoid surgery through Korean medicine treatment?

A. It is possible depending on the case. Since most surgeries for spinal stenosis are elective rather than emergency procedures, surgery can be postponed or avoided if pain and gait improve sufficiently through conservative treatment. However, if there is progressive muscle weakness or bowel and bladder dysfunction, surgery is the priority, and it is our role to honestly determine these boundaries for you.

Q I am a 72-year-old male. I promised my friends a trip to the Jeju Olle Trail, but now I cannot even walk 200 meters. If I receive treatment, will it be possible for me to walk for an hour again?

A. While it depends on the degree of stenosis and the patient's overall condition, it is not uncommon in clinical practice to see walking distance increase several-fold with conservative treatment. A realistic approach is to start at 200 meters and gradually increase the distance; by combining 2 to 3 months of treatment with complementary exercises such as cycling, you can even set a goal to complete long-distance courses by walking in short bursts.

Q I am a 70-year-old woman suffering from knee arthritis as well. Since I have lumbar spinal stenosis and knee pain at the same time, I do not know where to start treatment. Is it possible to treat both conditions together?

A. Yes, treating them together is actually closer to the principle. This is because there is a vicious cycle where if gait is compromised by stenosis, the burden on the knees increases; conversely, if activity decreases due to knee pain, the back muscles weaken, worsening the stenosis symptoms. Usually, we prioritize addressing the condition where pain is more severe and hinders walking, but we treat both conditions on the same day.

Q I am a 64-year-old man whose hobby used to be walking 10,000 steps a day. I can no longer walk for long periods due to spinal stenosis, but I have heard that I still need to exercise. What kind of exercise should I do and how?

A. For spinal stenosis, exercises that utilize the characteristic of a slightly bent-over posture are beneficial. Representative examples include indoor cycling, walking uphill on a slightly incline treadmill, swimming (freestyle and backstroke), and knee-chest pull stretches. Walking on flat ground for a long time while enduring pain can actually be counterproductive.

Q I am a 68-year-old woman who frequently cares for my grandchild. After being diagnosed with spinal stenosis, I feel at a loss as to what precautions I should take in my daily life. Please provide tips on managing daily life, covering everything from sleeping arrangements and chairs to housework.

A. When sleeping, lie on your side with a pillow between your knees, or if lying on your back, place a cushion under your knees to prevent your lower back from arching. Use a chair that does not sink too deeply to sit with your pelvis upright, and when holding your grandchild, it is a strict rule to bend your knees to lift them, not your lower back. Also, pay attention to keeping warm and managing your weight.

Q I am a caregiver looking after my 78-year-old mother. My mother has osteoporosis and is elderly; is it safe for her to receive moxibustion or bee venom acupuncture on her lower back?

A. While these treatments are feasible for the elderly and patients with osteoporosis, they require more meticulous safety management. Moxibustion is performed while confirming depth and location using ultrasound guidance, and bee venom acupuncture involves checking for allergies via a micro-skin reaction test and gradually increasing the concentration. It is a prerequisite to verify medications being taken and underlying diseases beforehand.

Q I am a 70-year-old male currently taking blood pressure medication and a painkiller (Lyrica). I would like to try taking herbal medicine for stenosis; is it safe to take herbal medicine in combination with the medications I am currently taking?

A. In most cases, it is possible to take them together if you space out the dosage by about two hours. However, you must provide the Korean medicine doctor with a complete list of the medications you are currently taking so that a safe prescription can be designed. Additionally, adjustments may be required in the selection of medicinal herbs for certain drugs, such as anticoagulants. Please do not stop taking painkillers on your own; be sure to consult with a doctor before making a decision.

Q I am a 63-year-old female real estate agent. The hospital says that my stenosis is degenerative and will gradually worsen. Does it really only get worse over time?

A. No. According to research, in a significant number of cases of mild to moderate stenosis, symptoms remain unchanged or even improve over several years. Rapid deterioration occurs in only a few cases, and the course varies greatly depending on exercise, weight, and treatment management. However, if you experience weakness in your legs or difficulty with bowel and bladder functions, an immediate detailed examination is necessary.

Q I am a 66-year-old retired civil servant. Once I start Korean medicine treatment, how long will it take to walk comfortably? I am curious about the treatment duration and the recovery process.

A. Although there is significant individual variation, the goal is generally to reduce pain within 4 to 6 weeks and extend walking distance over 2 to 3 months, based on treatment 1 to 2 times a week. The longer the duration of the disease and the more severe the stenosis, the longer the approach required. It is also advisable to allow for a management period to prevent recurrence even after symptoms have been brought under control.

Q I am a housewife in my late 60s. I have been told it is not a herniated disc, but if I walk even a short distance, my legs tingle and feel like they are about to burst, so I have to squat down. Why does spinal stenosis only cause pain when walking?

A. Spinal stenosis is a condition where the passageway for nerves (spinal canal) narrows. When standing or walking, the spine arches backward, further narrowing the passageway, which compresses the nerves and intensifies leg tingling and pain. Conversely, bending over or sitting widens the passageway, reducing symptoms; this is called neurogenic claudication.

Q I am a 58-year-old man who runs a small hardware store in Dong-gu, Incheon. I suffered from a herniated disc when I was young, and now I am told I have spinal stenosis. What is the difference between a herniated disc and spinal stenosis?

A. A herniated disc is a condition where a soft disc protrudes and compresses the nerve, while spinal stenosis is a degenerative disease in which the bones and ligaments thicken, narrowing the nerve passageway itself. Herniated discs tend to cause pain when bending over, whereas spinal stenosis tends to cause pain when walking with the back straight.

Q I am a 65-year-old housewife. Since being diagnosed with spinal stenosis, I have been looking for and eating foods that are said to be good for bones. Are there specific foods that help with spinal stenosis, or foods that I should avoid?

A. While specific foods do not cure stenosis, dietary habits influence symptoms through inflammation and body weight. A diet rich in protein, calcium, and vitamin D, along with a focus on oily fish and vegetables, is helpful. Conversely, it is advisable to avoid overeating, high-fat foods, excessive drinking, and sugary foods, as these can promote weight gain and inflammation.

Q I am a 59-year-old male working in parcel loading and unloading. Some days the pain is bearable, but on other days, my legs ache as if they are about to break. Are there specific behaviors or factors that suddenly worsen spinal stenosis?

A. Bending the back backward, lifting heavy loads, standing for long periods, and walking downhill are typical aggravating factors. Cold weather, weight gain, and smoking also exacerbate symptoms. Conversely, sitting with the back slightly bent or riding a bicycle are relatively comfortable activities.

Q I am a 71-year-old male living in Dong-gu, Incheon. It is difficult for me to travel frequently because I have to take the bus alone without the help of my children. What is the typical schedule for spinal stenosis treatment?

A. During the initial 2 to 4 weeks when pain is severe, intensive treatment is provided approximately twice a week. Once symptoms are under control, the frequency is gradually increased to once a week, followed by management sessions every other week or once a month. For patients with limited mobility, we adjust the schedule to reduce the burden of visits by combining acupuncture, moxibustion, and herbal injections into a single visit.

Q I am a 55-year-old male working near Dongincheon Station. I have been told that I have early-stage spinal stenosis, and I would like to know the entire process in advance regarding the sequence of treatment in Korean traditional medicine.

A. After confirming the location and type of stenosis through physical examination, imaging, and symptom evaluation, treatment begins with acupuncture. Based on the response, the treatment progresses through stages: fine needles (adhesion lysis), fire needles and thread embedding (tissue regeneration), and bee venom and pharmacopuncture (anti-inflammation). Simultaneously, herbal medicine tailored to the patient's constitution is used to regulate the body's foundation, while exercise and lifestyle modifications are performed concurrently.

Q I am a 61-year-old salon owner. I have been receiving acupuncture treatment for a few weeks, but it feels like the improvement has stalled. Is there a specific criterion for advancing the treatment level with moxibustion or pharmacopuncture in cases like this?

A. Yes, there is. Typically, if improvements in pain or walking distance stagnate even after 4 to 6 sessions of acupuncture, we consider moxibustion dissection, as adhesions or ligament hypertrophy are likely the primary causes. If inflammatory pain (nocturnal pain or pain at rest) is prominent, we may add bee venom acupuncture or pharmacopuncture first. Stagnation itself is a signal for the next stage.

Q I am a 67-year-old retired teacher. I was told that my spinal canal is very narrow according to the MRI. Isn't it impossible to widen an already narrowed passage with acupuncture or moxibustion? Is Korean traditional medicine really effective?

A. That is correct. Acupuncture cannot widen the narrowed bone structure itself. However, since a significant portion of the pain associated with spinal stenosis stems from inflammation, swelling, reduced blood flow around the nerves, and tension in the surrounding muscles, addressing these issues often leads to significant improvements in pain and walking distance, even if the underlying structure remains unchanged.

Q I am a 62-year-old woman who runs a restaurant in Dongincheon. I have received regular acupuncture several times, but the effect was only temporary. What is the difference between Dochim and Pharmacopuncture compared to regular acupuncture?

A. While regular acupuncture stimulates acupoints to relieve muscle tension and pain, Dochim is a treatment that uses a needle with a blade-like tip to directly separate thickened ligaments and adhered tissues. Pharmacopuncture and Bee Venom Acupuncture add anti-inflammatory effects by injecting purified medicinal components into the painful area. In cases accompanied by structural adhesions, such as spinal stenosis, the effects are deeper when combined in stages.