Many individuals with spinal stenosis believe nothing can be done. Others think surgery is the best or only option. Why? Because their MD said so, or a friend had the “same” condition, and it was the only thing that helped. However, surgery comes with significant risks not including the risk of FAILURE. Did you know the best predictor of spine surgery is prior spine surgery. More and more research supports an alternative treatment method for spinal stenosis…PHYSICAL THERAPY.
A recent study by Dr. Delitto and colleagues published in the Annals of Internal Medicine, randomized 169 patients with spinal stenosis into surgery or physical therapy groups. They followed these participants for 2 years, and found similar rates of functional improvement/quality of life measures in both groups. This data should make patients question the need for risky surgery. There are reasons surgery may be the best option, but there is work to do before that point. The study authors and other experts in the medical community stress an open/honest line of communication between the patient and their doctor on the reasons for or against surgery.
This research demonstrates a comprehensive physical therapy program can help a patient regain their quality of life. Any patient who thinks they will not have to put in effort pre or post surgery is mistaken. Those individuals are doomed to failure. Findings from the Maine Lumbar Spine Study report 1 in 4 patients who have spine surgery will have a 2nd procedure within 10 years. This data suggests careful consideration of the reason(s) for surgery in the first place. Effort must be taken to restore functional movement either to prevent surgery or during post surgery recovery.
In today’s healthcare environment where cost has become a bigger consideration in decision making, therapy is much cheaper and potentially equivalent in terms of functional outcomes to a surgery that will cost upwards of 80 thousand dollars. All patients with spinal stenosis should be advised that surgery is a last resort after all other conservative measures have failed, provided the patient put forth a good faith effort.
The bottom line as I like to leave the readers with is this…If one is dealing with spinal stenosis, start the dialogue with your physician and/or physical therapist about treatment options (it is never too early). Take an active approach to managing this condition and take control early rather than letting your quality of life suffer. Truly, spinal stenosis is a very slow process. If issues are addressed early, future negative consequences can be avoided. Do not wait until the spinal stenosis is significantly impacting your life in a negative way.
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