A study done at an academic medical centre in USA, investigated the functional differences between patients who received surgical intervention and ones who received exercise-based physiotherapy has concluded no difference at any point during their 2-year study.
Lower back pain (LBP) presents itself in many different forms and combination, some with restricted movements but minimum pain, some may report normal function except disabling at particular movement. Difference in presentation of pain and patterns is used to aid clinical diagnosis. Here the study focused on one particular group of LBP sufferers- spinal stenosis, meaning narrowing in spinal canal where it accommodates spinal cord, comparing the outcome difference between patients who received surgical and non-surgical (physiotherapy) intervention.
Target exclusion includes those who suffer from most severe form of spinal injury, severe heart disease, dementia, and whose age is less than 50 years old. With total number of participant at 147, they were randomly categorized to surgical and non-surgical group, where patients received physiotherapy twice a week focusing on particular exercises prescribed for lower limbs and lumbar spine.
The primary outcome measure used was physical function score at initial review, during the first 6 months, and at completion of study at end of 2 years. The result showed similar improvement when offered decompression surgery compared with physiotherapy.
Based on the result of this study, patients who suffer from spinal stenosis should be offered physiotherapy program in bid to improve symptoms and function before surgical option is considered.
Reference:
Hagen, K.B & Grotle, M (2016): No differences between physiotherapy and decompression surgery for patients considered surgical candidates for lumbar spinal stenosis [Synopsis]. Journal of Physiotherapy 62 (2016), 49