Lumbar spinal stenosis, a condition in which narrowing of the spinal column crowds the spinal cord causing serious pain, is frequently treated with spinal surgery. Spinal stenosis is not unusual as people age, but the surgery has a 15 percent complication rate in older individuals.
Now a study of 169 patients shows that physical therapy is just as effective as surgery at easing the low back pain caused by lumbar spinal stenosis. It is far safer, however.
Physical Therapy: Now or Later?
All of the patients had been planning to have surgery, but agreed to be randomly assigned to get surgery promptly or to try physical therapy. They were all at least 50 years old and had no heart disease, dementia or cancers.
Those assigned to physical therapy had twice weekly sessions for six weeks. During the two years of the study, just over half of those who started with physical therapy opted to follow up with surgery. Both groups had similar levels of pain reduction and other symptoms at the end of the two years.
Patients who have had back surgery almost always need physical therapy afterwards to recover. It makes just as much sense to try it first to relieve back pain and possibly be able to skip the surgery altogether.
Annals of Internal Medicine, online April 6, 2015