Lumbar spinal stenosis is a relatively common condition affecting older adults. Narrowing of the bony canals surrounding the spinal nerves due to arthritis and/or loss vertebral disc height increases the probability of nerve compression. Patient’s often describe leg pain greater than back pain, as well as, associated numbness, pins and needles, or weakness in their legs.
Physical Therapy involving manual therapy to the spine and hips, as well as, mobility and strengthening exercises, are a first line intervention for this population. Prior researchers have shown equivalent outcomes between lumbar surgery and Physical Therapy for patients with lumbar spinal stenosis. A recent randomized controlled trial examined the differences between a self directed home exercise program and a standardized in person Physical Therapy program.
Minetama and colleagues conducted a study on the effectiveness of in person Physical Therapy compared to a self directed home program for patients with lumbar spinal stenosis and neurogenic claudication (Clin Rehabilitation. 2021). Authors randomized patients to either a home exercise program or 12 Physical Therapy visits over 6 weeks. They reported lower pain and disability scores, as well as, lower rates of surgery in the supervised group compared to their peers who received a self directed home program. Authors concluded supervised Physical Therapy resulted in greater improvements in symptoms and physical function for this patient population.
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