Physical therapy treatment options for lumbar spinal stenosis

Background: Given the dearth of high quality research on conservative treatment for spinal stenosis, an empirical understanding of the scope of physical therapy provided in the community can help focus research and build standards of care. Objectives: Provide preliminary insight into current physical therapy practice in the treatment of lumbar spinal stenosis (LSS), from both patient and physical therapist perspectives. Methods: Patients greater than 50 years of age with LSS diagnosed by a spine surgeon were recruited to participate in a telephone survey regarding treatment. Physical therapists were recruited to complete a survey regarding treatments offered to patients with LSS. Results: Of the patients participating in the study (n = 75), 44 (59%) reported receiving physical therapy treatment. Treatments most frequently reported by patients were massage (27%), strengthening exercises (23%), flexibility exercises (18%), and heat/ice (14%). The most frequently advocated treatments by the 76 physical therapists included flexibility (87%), stabilization (86%) and strengthening exercises (83%), followed by heat/ice (76%), acupuncture (63%) and joint mobilization (62%). Conclusions: These results can guide both clinical research priorities and standards of care for physical therapy treatments of LSS. Based on the results of this study, future research foci should include massage, flexibility and strengthening exercises, stabilization techniques and heat/ice treatments.