Physical therapy for spinal stenosis is as effective as surgery and should be fully considered as a first-choice treatment option, according to a new study that is the first to directly compare a single, evidence-based physical therapy regimen with decompression surgery among patients who agreed to be randomly assigned to either approach.
The study focused on self-reported physical function among 169 participants diagnosed with lumbar spinal stenosis (LSS) after 2 years, but it also tracked function measurements along the way–at baseline, 10 weeks, 6 months, and 12 months. Researchers found that not only were 2-year effects similar for the 2 groups (87 who began with surgery and 82 who started with physical therapy), the increase in function followed similar trajectories from baseline on.
Those particular nonoperative physical therapy treatments administered to the participants included “instruction on lumbar flexion exercises including posterior pelvic tilts and supine knee-to-chest and quadruped flexion exercises; general conditioning exercises, including stationary cycling or treadmill walking; lower extremity strengthening exercises … ; lower-extremity flexibility exercises deemed appropriate … ; and patient education to avoid postures involving hyperextension of the lumbar spine,” authors write.
“Patients and health care providers should engage in shared decision-making conversations that include full disclosure of evidence involving surgical and nonsurgical treatments for LSS,” authors write, with Katz’s editorial arguing that “because long-term outcomes are similar for both treatments yet short-term risks may differ, patient preferences should weigh heavily in the decision of whether to have surgery for LSS.”
To learn more about spinal stenosis watch this video