Physical Therapy interventions for degenerative lumbar spinal stenosis: a systematic review.
Lumbar spinal stenosis (LSS) is a condition of narrowing of the central spinal canal, lateral recess or foramen, which can result in back and leg pain, disability and a decrease in quality of life. Although physical therapy (PT) is recommended for patients with mild to moderate LSS, little is known about the effect of PT. The purpose of this systematic review is to investigate the effectiveness of different types of PT in LSS.
A total of ten studies (only five RCTs) met the inclusion criteria and were used for analyses. The main results for physical therapist are 1) the use of exercise leads to better shot-term outcomes compared to no exercise, 2) the use of modalities (ultrasound, TENS, heat packs) and manual therapy have no additional benefit to an exercise program and 3) surgery is suggested to lead to better long term (2 years) outcomes however the results at short- and intermediate term are not different to PT.
A drawback of this study is the low quality and small number of studies. However this systematic review suggests that physical therapist should focus on an active approach in patients with LSS. > From: Macedo et al., Phys Ther (2013) (Epub ahead of print). All rights reserved to the American Physical Therapy Association.
The link to the article on Pubmed can be found here.