How to Navigate Spinal Stenosis

Low back pain affects millions of Americans each year leading to significant morbidity and loss of productivity.  There are many causes of low back pain including disc herniations, lumbar spine arthritis, and spinal stenosis.

Spinal stenosis is a specific condition where the spinal cord and its nerve roots are compressed causing pain that radiates down to the legs and a feeling and sensation of tiredness leading to decreased ambulation (pseudo claudication).  Treatment options for this condition have included rest, anti-inflammatory medications, exercise therapy, and surgical decompression of the spine.

Surgery, while it can be successful, also poses significant risks to patients.  Therefore, it is best left as the last resort.  Fortunately, it turns out that the majority of patients with spinal stenosis.  In a recent study published in the Annals of Internal Medicine, researchers showed that in a group of patients randomized to either surgery or twice-weekly therapy for spinal stenosis that clinical outcomes at the latest follow-up were similar between the 2 groups.  A major flaw in this study was that a large number of patients refuse to participate in this randomized controlled trial.

While this study does not fully prove that therapy is all you need for your low back pain, it suggests that therapy is a reasonable starting point for patients with low back problems.  Of course, not all back conditions have the same prognosis or treatment pathways, so please consult your doctor.