Physical Therapy Beats Surgery
for Lumbar Spinal Stenosis (LSS)


Spinal stenosis is a degenerative condition of the vertebrae that causes the spinal canal to narrow, placing pressure on discs and nerves. When located in the low back, or lumbar spine, stenosis can cause pain and reduce function in the back, buttocks and lower extremities.


Many people seek surgical decompression to try to manage the symptoms of pain, numbness, tingling and weakness that characterize lumbar spinal stenosis (LSS), but surgery often fails to render long-lasting results because it treats the symptoms of stenosis without addressing the underlying causes.

Study Comparing Surgical Decompression to Physical Therapy for LSS

In a recent study, Delitto et al. (2015) sought to compare the efficacy of surgical decompression to physical therapy treatment for LSS. Here are the details:

  • Study Participants: 169 surgery-eligible participants with LSS over age 50.
  • Study Design: Participants were randomly assigned to either surgery (87) or physical therapy (82), with a 24-month follow-up. The study took place from November 2000 to September 2007.
  • Results: The research team found no significant differences in outcomes between the two groups at a 24-month follow-up.
  • Conclusion: Patients should be provided with full disclosure about surgical and non-surgical treatment options.

Avoiding Surgery Risks and Expense with Physical Therapy Rehab

Decompression surgery for LSS carries with it inherent risks for patients, which should not be taken lightly.

Risks include:

  • General risks associated with anesthesia
  • Injury to nerves or your spinal cord
  • Failure to heal properly
  • No improvement post-surgery
  • Infection and pain at the surgery site
  • High medical expenses
  • Prolonged recovery time

Physical therapy, on the other hand, carries with it minimal risks, and multiple benefits, including improved overall fitness, improved function, and improved spinal range of motion. PT requires no recovery time, and you will see gradual improvements over the course of your treatment.

In most cases, a surgeon will recommend physical therapy as a follow-up treatment to LSS decompression surgery.

Best Physical Therapy NYC

If you are seeking a physical therapist in Manhattan, our midtown physical therapy clinic is the best. We employ a broad range of innovative therapies and technological solutions to help our patients relieve pain and restore function, If you suffer from LSS or other back or joint pain, contact us today, and put yourself on the road to recovery for a better quality of life.


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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