Jan 18

LUMBAR SPINAL STENOSIS: What do to?

Lumbar spinal stenosis (LSS) is reportedly one of the most common spinal conditions in the US, affecting more than 500 million people over 65 years old. (1) As researchers grapple with a more systematic approach to managing patient care for lumbar spinal stenosis sufferers, your chiropractor delivers gentle, safe, relieving treatment. The latest attempt at a systematic approach emphasized that each LSS patient presents a bit differently which limits any algorithm to be “soft guidance” as to its treatment plan based initially on the LSS patient’s pain relief with spinal flexion. (2) Since spinal stenosis is typically a systemic issue, meaning if you have spinal stenosis in the lumbar spine, you likely have it in other spinal areas like the cervical as well, you don’t want to ignore it. Further, lumbar spinal stenosis is not a condition that appears and disappears forever. Its pain can be managed, but its status as a condition remains one that researchers classify as “chronic,” meaning it lasts beyond 90 days. Have hope! Your chiropractor can help. One study reported that flexion distraction significantly reduced pain and disability for lumbar spinal stenosis patients. (3) Another study reported that chronic back pain sufferers with moderate to severe symptoms improved most with the chiropractic technique, Cox® Technic Flexion Distraction Decompression (CTFDD), compared with physical therapy. (4) Those same patients had significantly lower pain scores over the following 12 months than did patients who underwent physical therapy. (5) LSS patients also experience altered gait and balance issues. (1,6) CTFDD helps these issues, too! A study regarding the influence of spinal manipulation on balance issues found in LSS patients documented that flexion distraction spinal manipulation improved function, symptoms, and performance-based mobility in patients with lumbar spinal stenosis. (6) We also look forward to the outcomes of a prospective data collection study in its second year for follow-up with patients who underwent CTFDD for relief of their LSS related back pain. Data collection will be completed in late 2023 with results being published in the years to come. Lumbar spinal stenosis is everywhere, and your chiropractor is its relieving partner!

Listen to this PODCAST with Dr. Dean Greenwood on The Back Doctors Podcast with Dr. Michael Johnson as he explains his relieving treatment of a spinal stenosis patient with The Cox® Technic System of Spinal Pain Management.

TIP OF THE MONTH:

Stretch, Strengthen, Walk for LSS Improvement

As a set of researchers establishes a new study to see if a 6-week education and exercise program will improve the walking capacity of lumbar spinal stenosis patients who also have neurogenic claudication (7), we suggest walking and exercising now! Much research shows that lumbar spinal stenosis responds to exercise. One study showed that individualized exercise (stretches and strengthening) combined with manual therapy (like out CTFDD spinal manipulation mobilization!) beat medical care and group exercise with greater symptom and function improvement as well as walking capacity at 2 months of care. (8) We have just the program of stretching, strengthening, and manipulation for you!

Happy 2023! 

We look forward to the privilege of taking care of your spine.

References for HEALTHY NEWS – January 2023

  1. Wang J, Ullah S, Solano MA, Overley SC, Bumpass DB, Mannen EM. Changes in kinematics, kinetics, and muscle activity in patients with lumbar spinal stenosis during gait: systematic review. Spine J. 2022;22(1):157-167. doi:10.1016/j.spinee.2021.06.003
  2. Antony A, Stevenson J, Trimble T, Block J. Perspective: A Proposed Diagnostic and Treatment Algorithm for Management of Lumbar Spinal Stenosis: An Integrated Team Approach. Pain Physician. 2022;25(9):E1467-E1474.
  3. Choi J, Lee S, Jeon C. Effects of flexion-distraction manipulation therapy on pain and disability in patients with lumbar spinal stenosis. J Phys Ther Sci. 2015;27(6):1937-1939. doi:10.1589/jpts.27.1937
  4. Gudavalli MR, Cambron JA, McGregor M, et al. A randomized clinical trial and subgroup analysis to compare flexion-distraction with active exercise for chronic low back pain. Eur Spine J. 2006;15(7):1070-1082. doi:10.1007/s00586-005-0021-8
  5. Cambron JA, Gudavalli MR, Hedeker D, et al. One-year follow-up of a randomized clinical trial comparing flexion distraction with an exercise program for chronic low-back pain. J Altern Complement Med. 2006;12(7):659-668. doi:10.1089/acm.2006.12.659
  6. Smith DL, Olding K, Malaya CA, McCarty M, Haworth J, Pohlman KA. The influence of flexion distraction spinal manipulation on patients with lumbar spinal stenosis: A prospective, open-label, single-arm, pilot study. J Bodyw Mov Ther. 2022;32:60-67. doi:10.1016/j.jbmt.2022.05.012
  7. Houle M, Tétreau C, Châtillon CÉ, Marchand AA, Descarreaux M. Effectiveness of a 6-week specific rehabilitation program combining education and exercises on walking capacity in patients with lumbar spinal stenosis with neurogenic claudication: a randomized controlled clinical trial protocol. Trials. 2022 Dec 27;23(1):1046. doi: 10.1186/s13063-022-07011-3. PMID: 36572884; PMCID: PMC9793648.
  8. Schneider MJ, Ammendolia C, Murphy DR, Glick RM, Hile E, Tudorascu DL, Morton SC, Smith C, Patterson CG, Piva SR. Comparative Clinical Effectiveness of Nonsurgical Treatment Methods in Patients With Lumbar Spinal Stenosis: A Randomized Clinical Trial. JAMA Netw Open. 2019 Jan 4;2(1):e186828. doi: 10.1001/jamanetworkopen.2018.6828. PMID: 30646197; PMCID: PMC6324321.