Does Physical Therapy Really Help With Degenerative Lumbar Spinal Stenosis?

Physical Therapy Interventions

What is Physical Therapy?

A patient may receive physical therapy when he or she has had an injury, disease or a deformity. Physical therapy involves treatments such as massages, heat treatments, and also certain routine exercise.

Why Should You Get Physical Therapy?

People with certain physical problems may have trouble moving around and doing everyday tasks. It can help ease the pain, and help restore physical activity when it was not able to do so before.

Symptoms of Degenerative Lumbar Spinal Stenosis?

Patients who have Degenerative Lumbar Spinal Stenosis usually complain of symptoms with lower back pain. They may also have weakness in some areas and numbness in the legs.

Studies That Were Done on Degenerative Lumbar Spinal
Stenosis and Physical Therapy

In some studies, there were no improvements or effects from having physical therapy to help with this condition.  Some other studies indicated that physical therapy has a positive impact on recovery.

What Are the Limitations?

Many people have different opinions on what can help with Degenerative Lumbar Spinal Stenosis. This article is not trying to claim that surgery is or not the best way to go. It is also not trying to claim that physical therapy will cure this condition either. This article is just here to inform you about what some people have done, and what has worked for them. So, as a result, this article is not trying to conclude which physical therapy treatment would be best.

Lumbar Spinal Stenosis, also known as LSS, is when the central spinal canal, foramen, or lateral recess is narrowed. This leads the common pain that one may feel in his or her back or even leg pain. This condition limits one’s ability to be mobile without feeling pressure in those areas.

One fact that is really interesting is that Lumbar Spinal Stenosis has become more common in adults who are sixty years and older. There has also been a rise in spine surgeries because of this condition over the past couple of decades.

When a patient has a mild or moderate condition of Lumbar Spinal Stenosis, physical therapy may be recommended. When a patient has a severe case, he or she usually has to get surgery; but, first, he or she has to go through some trials of different treatments before jumping directly to surgery.

A study in Canada has shown that many patients receive physical therapy because of this condition. The various treatments in physical therapy ranged from massage to exercises that strengthen the muscles, flexion exercises, aerobic exercises, and working with braces or other devices to help them walk; however, the majority of these patients received massage over all of the other treatments.

One thing to keep in mind while reading this article is that even though many patients are receiving physical therapy care for LSS, it does not mean that these treatments are one-hundred percent guaranteed effective. It is important to learn about all the different treatments that can help with this condition, but one must decide which treatment is the best for him or her.

As of now, there is no known physical therapy treatment that works with ALL patients. Each treatment in physical therapy is different. Many patients have commented on how physical therapy has helped them relieve some of the pain and help them with their mobility and exercise. Some of their treatments include steroid injections; these are not really physical therapy treatments. These patients have claimed that physical therapy has worked because they took injections, but that is not what physical therapy is really about for helping this condition.

In other studies, with physical therapy and other conditions along with LSS, there was no found evidence that there was a significant impact or difference by doing the exercises that were instructed to do by physical therapists. Again, reviewers have found that surgery seemed to help the condition; however, exercise should always be considered to help with any condition before considering a major surgery to correct something.

This article is to inform you of some information and studies about the effectiveness of having physical therapy to help LSS.

Let’s Take a Look at Some Results!

Again, as stated before, when there is a severe case of Degenerative Lumbar Spinal Stenosis, surgery is usually referred to right away by doctors. When there are light or mild cases of it, patients have the option to visit a physical therapist to see what it can do for them.

According to a randomized controlled trial which was used to evaluate the effectiveness of treatments in patients who had physical therapy for LSS, it showed that the treatments did not seem to help the pain. This was within a two to three-week period. It also did not help with the disability itself or even walking. From the result of Individual Studies, which were not pooled, It had the same outcome that the exercise program that was done in physical therapy to help patients didn’t seem to affect the pain or mobility.

There is another study about a treadmill walking with body weight treatment. This physical therapy treatment was shown that it is really not any better than cycling. This study was done within a three to a six-week time period. Overall, these studies proved that the activities and exercises done in physical therapy were no different or more special than any normal activity one would do on a normal day.

Corsets were also brought into some studies to see how well they could help patients with pain and mobility with LSS. The patients had to walk on a treadmill. Some of the patients had to walk on the treadmill with a corset or without. Other patients were told to walk on a treadmill doing both with the corset. Results showed that pain levels were better with a corset than without. The pain severity was lessened when patients were tested for their walking ability with a corset, and also for their total walking distance. A corset with a 25 weight reduction was better than the corset with no weight reduction called the lumbar corset; however, the concluding results also showed that using the corset does not mean that it will be helpful to all, and it is not proven that it will one-hundred percent be better than with a patient not wearing a corset at all.

Reviewing with Caution

When looking into treatments and help for an LSS condition, it is important to take all patient reviews into consideration, but proceed with caution. The evidence that these treatments truly work is a very low percentage. This includes the claim that physical therapy and exercise is better than doing no exercise at all to relieve back and leg pain. All of these claims are still questionable, and there is no significant evidence proving one thing or another.

It is possible that if more patients were assessed, there could be more statistically data proving what can truly help with LSS. One thing to point out though is that all the results will still vary, but pain may likely to be smaller with clinical help. As for the treadmill walking physical therapy that is used to support the patient’s body weight, there is also not enough data or evidence to prove that this technique is better than cycling to relieve pain.

There is some evidence that has more data that seems to show that surgery helps patients with pain and mobility long term than to do nothing at all, or to just stick with physical therapy. The mean of the statistical data, however, was very small. This still makes this claim questionable, and the information should be taken with caution. As for using the corset while walking, that also didn’t have enough statistical evidence that is proven to support patients’ needs for LSS symptoms; however, a 25 percent reduction of weight was better than no reduction. This should be taken note for.


There isn’t enough data or information to make any sort of claim that something will help fix, solve, or easy any pain or discomfort in back or leg pain. After taking all of this into consideration, physical therapists and doctors need to redirect their studies into finding a way to help these patients than just giving them physical therapy treatments that have very low significant evidence or actually being successful.

Future studies should also look into the corset treatments. Studies did show that the 25 percent reduction was better than none at all, so maybe more research should be done in this area so that it can improve treatments.

As for surgery, some studies showed that it had a higher impact on those who did not have surgery for LSS, however, the data and statistical information is at a low percentage. Claims should not be made or given to patients that surgery will help because evidence and data do not suggest that, yet.

Most of these reviews or studies that have been done on corsets, treadmill walking, surgery, aerobic exercises and more are very weak. There isn’t enough variation or testing being done to prove anything. This is the number one factor that makes it so hard to compare treatments and which one is better than the other. Programs are also not really described. If you think about it, all physical therapists have a different way to do something. There really isn’t a controlled variable, and they’re all doing their treatments different due to differentiation. In order for these studies to be true, instructions and procedures need to be written out and defined for all physical therapy treatments. An example of this was the study with steroids that was mentioned earlier. Some patients claimed that they had steroid injections for their physical therapy treatment, but that is not a physical therapy treatment whatsoever; therefore, they cannot say that the physical therapy treatment that they were receiving was successful because it wasn’t a physical therapy treatment.

In addition to all of the pain factors and studies that were talked about dealing with pain, this has to be taken into consideration as well that the results are biased or not accurate because not everyone will be on the same medicine, if on any pain medicine at all with their physical therapy treatments or surgeries.

Many people think that if they read some reviews or studies that this treatment or that treatment was successful, they have to look at the bigger picture that not all of the statistical data is correct. You have to take into consideration of the control variables, how many people were studied, what were the comparisons, was there any pain medication involved, and the total time period that the patients were being studied. After all of these studies, there is no true evidence that physical therapy will help with a condition. The same applies towards surgery. It may be recommended by a doctor, but there still hasn’t been significant evidence of any differences in pain levels after any of the treatments. Future studies need more data and time in order to make worthy claims about whether or not physical therapy can help a patient.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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