Calcitonin treatment in lumbar spinal stenosis: A randomized, placebo-controlled, double-blind, cross-over study with one-year follow-up

Abstract

A randomized, placebo-controlled, double-blind, crossover study in 40 lumbar spinal stenosis patients with a 1-year follow-up showed that calcitonin had beneficial effects on the patients' symptoms without producing any notable side effects. Calcitonin had a clear analgesic effect. The mean of walking distance increased, but the crossover trend was not as good as the analgesic effect. Side effects such as erythema and nausea were usually mild and transient. Calcitonin therapy can be used as a conservative treatment in selected cases of lumbar spinal stenosis. When rest pain was mild or the walking distance was under 200-300 m because of neurogenic claudication, the effect of calcitonin seemed to be poor.

Investigating non-operative treatment options for lumbar spinal stenosis

“…Also, unexplained is the report of statistically significant differences with an improvement of 5 mm for the calcitonin and a deterioration of 11 mm for placebo (P = 0.03) on visual analog scale for 'back pain'. The results of our study in 2004 were in contrast to several previous trials in the literature reporting subcutaneous calcitonin as effective in treating symptomatic spinal stenosis [1,2,7,[9][10][11]. One potential explanation for this disparity is the formulation of calcitonin that we used.…”

Lumbar spinal stenosis: a brief review of the nonsurgical management

“…Furthermore, at one year, none of the two groups experienced residual benefits. 25 In 2004, Podichetty et al 26 recruited 47 patients and compared a six-week regimen of intranasal calcitonin with placebo. At six weeks, no differences in pain, walking distance, walking time, and physical or emotional function were found between the …”

“…In 1992, Eskola et al 25 conducted a double-blind, crossover RCT on 39 patients suffering from LSS. The subjects initially received a subcutaneous injection of calcitonin or placebo every other day for four weeks.…”

“…24 Alternately, calcitonin can decrease the vascular supply to the bone by lowering its metabolic activity, thus allowing more blood to reach the compromised neural tissues. 25 To date, four RCTs have investigated the use of calcitonin in LSS.…”

Nonsurgical management of spinal stenosis: how evidence-based are we?

“…Cuckler et al reported a lumbar epidural approach without fluoroscopy. 4 Surprisingly, a second epidural was given for ethical reasons and not technical failures. In the only positive study evaluating calcitonin, a crossover design was used after a two-month washout period.…”