May 30

Relieving Care for Lumbar Spinal Stenosis Back Pain

OUR ‘THING’ – Relieving Care for Lumbar Spinal Stenosis Back Pain

Lumbar spinal stenosis (LSS) is a degenerative spinal condition affecting many older adults. Lumbar spinal stenosis is a huge problem for a lot of people – 103 million worldwide – and 11% of older US adults which increases with age. (1) LSS comes and goes and may deteriorate over time. Standing and walking may aggravate it while sitting and bending forward usually improve it. (3) Typical medical recommendations are to modify activity, analgesia, physical therapy, and even epidural steroid injections whose long-term benefits are being questioned. (2) Non-medical recommendations are reported as effective, especially a mixed approach of manual therapy and exercise for older patients experiencing lumbar spinal stenosis with neurogenic claudication that was described as effective while epidural steroids were not. (3) A recent report emphasized the desire of chiropractors to collaborate with healthcare professionals to improve integrated, coordinated patient centered healthcare for older adults, the number of whom is growing rapidly. (4) We chiropractors offer multiple non-drug, non-surgical approaches via individualized treatment plans – spinal manipulation and mobilization like Cox® Technic, nutrition, exercise, bracing, etc. – to relieve spine-related pain like back pain due to LSS. Spine pain relief is our ‘thing’!

Listen to this PODCAST with Dr. Keith Bartley on The Back Doctors Podcast with Dr. Michael Johnson about the use of The Cox® Technic System of Spinal Pain Managementtreatment protocols to successfully manage lumbar spinal stenosis. 

TIP OF THE MONTH:  Do Your ‘Thing’: Exercise for LSS 

Of three non-surgical interventions for lumbar spinal stenosis – medical care, group exercise, and manual therapy/individualized exercise – manual therapy/individualized exercise provided greater short-term symptom and physical function improvement as well as better walking capacity. (5) That’s our approach! We use the gentle Cox® Technic manual therapy with exercise. A recent review of exercise for lumbar spinal stenosis and related neurogenic claudication found that most exercise recommendations featuring supervision, lumbar flexion, and aerobic fitness exercises (like cycling in a flexed posture) while stretches, strengthening exercises, and psychologically informed approaches were part of the most effective approaches. (6) If lumbar spinal stenosis is your ‘thing,’ exercise will most likely be your ‘thing,’ too! We figure out the best ones for you, together.

Thank you for being part of our chiropractic healthcare family.

We look forward to seeing you soon!

References for HEALTHY NEWS – May 2024

  1. Katz JN, Zimmerman ZE, Mass H, Makhni MC. Diagnosis and Management of Lumbar Spinal Stenosis: A Review. JAMA. 2022 May 3;327(17):1688-1699. doi: 10.1001/jama.2022.5921. PMID: 35503342.
  2. Webb CW, Aguirre K, Seidenberg PH. Lumbar Spinal Stenosis: Diagnosis and Management. Am Fam Physician. 2024 Apr;109(4):350-359. PMID: 38648834.
  3. Ammendolia C, Hofkirchner C, Plener J, Bussières A, Schneider MJ, Young JJ, Furlan AD, Stuber K, Ahmed A, Cancelliere C, Adeboyejo A, Ornelas J. Non-operative treatment for lumbar spinal stenosis with neurogenic claudication: an updated systematic review. BMJ Open. 2022 Jan 19;12(1):e057724. doi: 10.1136/bmjopen-2021-057724. PMID: 35046008; PMCID: PMC8772406.
  4. Bergström C, Axén I, Field J, Hartvigsen J, van der Marck M, Newell D, Rubinstein S, de Zoete A, Persson M. The chiropractors’ dilemma in caring for older patients with musculoskeletal complaints: Collaborate, integrate, coexist, or separate? PLoS One. 2024 May 2;19(5):e0302519. doi: 10.1371/journal.pone.0302519. PMID: 38696495; PMCID: PMC11065304.
  5. 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.
  6. Comer C, Williamson E, McIlroy S, Srikesavan C, Dalton S, Melendez-Torres GJ, Lamb SE. Exercise treatments for lumbar spinal stenosis: A systematic review and intervention component analysis of randomised controlled trials. Clin Rehabil. 2024 Mar;38(3):361-374. doi: 10.1177/02692155231201048. Epub 2023 Sep 16. PMID: 37715644; PMCID: PMC10829420.