Q&A: Do I have to take this tablet for the rest of my life?

Questions:

I have been diagnosed with spinal stenosis. I used to enjoy walking but I am now finding that walking can be more painful for me than sitting down. I have been prescribed gabapentin and my enquiry is, will I have to take this for the rest of my life?

-Dorothy

Answer:

Dr Sarah Jarvis says: “Spinal stenosis is a narrowing of the spinal canal, down which your spinal cord runs. This can press on the nerves in the spinal cord and cause severe pain and sometimes numbness or weakness of the legs. Many people get ‘claudication’ – symptoms that come on after walking a specific distance and aren’t present at rest.

The outlook for spinal stenosis depends to an extent on the cause – it’s most commonly caused by degeneration of the spine over time due to wear and tear. Gabapentin was first developed to treat epilepsy. However, like many epilepsy drugs and medicines developed to work on conditions of the nervous system, it became clear that it can be a very effective treatment for other conditions affecting the nervous system, including nerve pain, or ‘neuralgia’.

Spinal stenosis , as a very rough approximation, gets better over time in about 1 in 5 people, stays the same in 3/5 and gets worse in about 1 in 5). gabapentin can be very effective, but often causes side effects such as drowsiness, which can be severe. If your symptoms do not improve or they get worse, your doctor may recommend spinal injections such as epidural or nerve root blocks, using local anaesthetic and steroids. These may be effective enough for you to be able to reduce or stop other medication. In severe cases, surgery may be considered. While this isn’t undertaken lightly, it can produce significant improvements.”

-Dr Sarah Jarvis