Ask Your Physical Therapist: Surgery vs. therapy for spinal stenosisDecember 14, 2015
Many individuals with spinal stenosis may think surgery is the best and only option.
Their doctor may have told them it is the only option, or a friend had the “same” condition, and it was the only thing that helped.
However, surgery comes with significant risk, not including the risk of failure. More and more research is starting to support an alternative treatment method ... physical therapy.
A recent study by Dr. Anthony 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 over two years and found similar rates of functional improvement/quality of life measures in both groups.
This data should make patients question the need for immediate and risky surgery. There are certainly reasons why surgery may be the best option, but the study authors and other experts in the medical community stress an open/honest line of communication between the patient and doctor on the reasons for or against surgery.
The potential shown by research is that a standardized physical therapy program can enable a patient to regain their quality of life. Any patient who thinks he or she will not have to put in effort pre- or post-surgery is mistaken and doomed to failure.
Findings from the Maine Lumbar Spine Study report that nearly one in four patients who have spine surgery will have a second procedure within 10 years. This data suggests careful consideration of the reasons for surgery in the first place.
Effort must be taken to truly restore functional movement either to prevent surgery or during post surgery recovery.
In today’s health care environment where cost has become a bigger consideration in decision making, therapy is much cheaper and is potentially equivalent in terms of functional outcomes to a surgery that will cost upward of $80,000. All patients with spinal stenosis should be advised that surgery is a last resort when 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 if one is dealing with this condition, 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.