The Crazy Thing Research is Telling Us About Spinal Stenosis

In Back Pain, Physical Therapy by Seth Peterson, Physical Therapist Oro Valley

Lumbar Stenosis is a radiographic diagnosis.  The word “lumbar” refers to the lower back and “stenosis” means “narrowing.”  Usually, when an x-ray or MRI finds that you have stenosis, it means that the passageways for nerves in your spine are smaller.  However, it is important to keep in mind that this narrowing can happen without pain.  It is common to find stenosis on both sides of the spine, while you may only have symptoms on one side, for example.  Sometimes, a doctor may diagnose a patient with having stenosis without any imaging.  What this means is that the person fits a presentation that is like stenosis.  Patients with stenosis often have radiating leg pain when walking for long periods, which immediately abates when sitting.  If this is something that you struggle with, then you’ll be happy to know that there has been a lot of promising research in this area lately!  The purpose of this article is simply to update you with some of the recent findings as it pertains to managing patients with spinal stenosis – and some of them may be surprising!

Patients Often Improve With Exercise and Physical Therapy

In one recent study found here, people with lumbar stenosis were found to improve their walking ability within only 2 months.  In this study, the 3 arms of the study were: pain medication, self-directed exercise, and physical therapy.  All people participating in the study improved their walking tolerance, but the physical therapy group had the largest pain reduction —even better than the treatment arm where participants took pain medication!  

Those familiar with the research on non-surgical management of lumbar stenosis may recall a study from 2015 in which physical therapy was shown to be equal to surgery (lumbar decompression ) for patients with lumbar stenosis.  The authors suggests that patients have in-depth conversations with any surgeons about the potential harms of surgery and whether physical therapy would be beneficial.  In our clinic, we routinely see patients with lumbar spinal stenosis improve, and would also be happy to answer any questions. If interested, you can find that article here.

Finally, you might be thinking, “can’t I just find some YouTube videos and do my own exercise routine?”  If so, you might end up stumbling upon our own video of common exercises for lumbar stenosis.  However, according to research published just this year, you’d be shortchanging your recovery.  A recent study found that supervised physical therapy was significantly more effective than a home exercise program for spinal stenosis.

What Patients Prefer

Patient preference is important.  One of the great things about the research recently published is that patients were finally being asked what they value.  It was interesting to see some commonalities.  

According to a study in the journal Spine, most patients with spinal stenosis prefer an individualized treatment plan.  They also want to do more at home and less in the clinic.  Patients felt that spinal stenosis was a lifelong condition and wanted to improve their ability to self-manage their condition, but to do so in a way that was specific to their needs.

Another study by Lynch and colleagues in the journal Spine showed many of the same things – that patients wanted to be given appropriate education and time to discuss the issue with their doctor along with having a customized treatment plan.  Patients in this study also reported feeling an emotional reaction to the diagnosis of stenosis, something that they didn’t feel that they fully understood. 

If you are reading this and are struggling with spinal stenosis or know someone else who is, feel free to jump over to our webpage here and check out our free ebook about low back pain.  As a 1-on-1 physical therapy clinic, we’ve designed ourself to provide enough time to discuss each patient’s unique diagnosis with them and provide a customized treatment program to meet their needs. You’ll be with the same therapist every time and go to a clinic in the top 1% nationally for “efficiency” — or using fewer visits to get you better.  This means more to do at home and fewer doctor’s visits.  

Feel free to connect with us below, with email, on social media, or by dropping by!  I’ll do my best to keep you updated on the science behind movement and pain so you can continue to live your best life!