Lumbar spinal stenosis, a common cause of low back pain, occurs when the open spaces within the spine become narrow and puts pressure on the spinal cord and the nerves that travel through the spine. Most commonly caused by wear-and-tear changes in the spine related to aging, the symptoms of the condition include pinched nerves, tingling, and weakness and numbness in the back and lower extremities. According to the American Academy of Orthopedic Surgeons, an estimated 2.4 million Americans will be diagnosed with spinal stenosis by the end of 2021.
Surgery is sometimes recommended to treat the condition. However, a new study suggests that physical therapy could be as effective as surgery to tackle lumbar spinal stenosis and should be considered as a first-choice treatment option. The study, conducted by researchers at the University of Pittsburgh, directly compared a single, evidence-based physical therapy regimen with decompression surgery and found nearly equal success between the treatment modalities for degenerative low back pain.
The researchers analyzed about 169 participants (age 50 years and over) who were diagnosed with lumbar spinal stenosis via MRI and had pain while walking. However, they could walk a quarter of a mile without difficulty and had no serious medical conditions like cancer. All had agreed to have surgery.
Of the participants, 87 were assigned to have surgery for LSS, while 82 underwent physical therapy. The exercise regimen consisted of twice-weekly rehabilitation sessions for six weeks. They were allowed to opt out of the program any time and choose surgery and 57 percent did that.
It was found that regardless of the group they started in, the participants reported similar reduction of pain and other symptoms at two years.
The results of the study show that both surgery and physical therapy are reasonable choices for treating lumbar stenosis. However, Anthony Delitto, the lead author of the study says that people should first consider exhausting all non-surgical options and that surgery should be the last resort. He says that the study shows that people don’t do so.