Case Report: The Successful Use of Hydroxyzine for Analgesia in a Patient With Lumbar Spinal Stenosis.

Background: Lumbar spinal stenosis is a chronic condition associated with low back pain that is usually alleviated with traditional pain medications, spinal injections, or surgery. Antihistamines are a drug class that are not usually used for analgesia.

Case report: We present the case of a 51-year-old woman who presented with low back pain radiating down the right lower extremity. Magnetic resonance imaging of the lumbar spine revealed multilevel degenerative changes, including bilateral foraminal narrowing at L5-S1. Despite conservative treatments, her pain persisted. A trial of 10 mg hydroxyzine 3 times daily led to a 50% reduction in reported pain.

Discussion: Hydroxyzine is an H1 inverse agonist not commonly used for analgesia. Potential mechanisms include antagonizing H1 receptors on lumbar nerve roots and interaction with neural cytokines.

Conclusions: Improvement after the use of antihistamines for lumbar stenosis pain is rare and leads to consideration of its use as a treatment option.