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Spinal Stenosis Physiotherapy

by | Jul 15, 2026 | Uncategorized | 0 comments

Physiotherapy can help prevent spinal stenosis surgery

A study found that physiotherapy is just as effective as surgery in treating spinal stenosis (Delitto et al., 2015)

What is spinal stenosis?  

Spinal stenosis is a condition that happens when the spinal canal is too narrow. The spinal canal is a tunnel-like passage made up of the backbone, spinal cord, and nerves surrounded by cerebrospinal fluid. When the spinal canal is too narrow it can cause nerves to become compressed, irritated, and/or pinched leading to numbness, pain, and in rare cases paralysis.

Spinal stenosis symptoms

Spinal stenosis can happen anywhere on the spine. However, it usually occurs in the lower back (lumbar) and neck (cervical) regions. The symptoms of spinal stenosis usually develop gradually and depend on the location and severity of the narrowing. Typically, spinal stenosis causes severe pain in the regions associated with the affected nerves. For example, if the narrowing is in the lower back, the pain will be felt in the legs. Other common symptoms include:

Lumbar spinal stenosis:
• Leg and low-back pain especially while standing or walking
• Low-back pain that radiates down the legs
• Numbness/tingling and/or weakness in the legs

Cervical spinal stenosis:
• Neck pain
• Pain that radiates down the arms
• Numbness/tingling and/or weakness in the arms and hands

Spinal stenosis causes

Spinal stenosis may be present at birth (congenital) or result from injury and/or medical conditions (e.g., osteoarthritis and Paget disease). However, it is mostly caused by age-related wear and tear (Melancia et al., 2014).
Treatments
Until recently, spinal surgery had been the first-line treatment for symptomatic spinal stenosis (Weinstein et al., 2006). In the United States alone, more than 800,000 surgeries to decompress the spine have been performed between 2003 and 2012 (Poorman et al., 2018). Now, many people have shifted towards less invasive treatment options such as physiotherapy to manage their symptoms. Physiotherapy has been shown to be an effective treatment option for spinal stenosis (Hagen et al., 2016).
The research
A study published in the journal of Annals of Internal Medicine compared the effectiveness of surgery versus physiotherapy on the treatment of spinal stenosis (Delitto et al., 2015).
The study included 169 patients suffering from lumbar spinal stenosis. All patients were over the age of 50 and reported pain being at least a 7 out of 10.

The researchers randomly divided participants into one of two treatment groups:

1. Physiotherapy

2. Surgery

The physiotherapy group attended treatment sessions twice a week for 6 weeks. The treatment consisted of various exercises including flexion exercises, walking, stretching, and strengthening.
Immediately and two years after treatment, the researchers followed up with participants. They found that physiotherapy and surgery equally reduced symptoms such as pain and improved functionality.

Overall, the results of this study suggest that physiotherapy is as effective as surgery in relieving spinal stenosis symptoms, reducing the need for decompression surgeries.

References

Delitto, A., Piva, S. R., Moore, C. G., Fritz, J. M., Wisniewski, S. R., Josbeno, D. A., Fye, M., & Welch, W. C. (2015). Surgery versus nonsurgical treatment of lumbar spinal stenosis a randomized trial. Annals of Internal Medicine, 162(7), 465–473. https://doi.org/10.7326/M14-1420

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(1), 49–. https://doi.org/10.1016/j.jphys.2015.09.003

Melancia, J. L., Francisco, A. F., & Antunes, J. L. (2014). Spinal stenosis. Handbook of clinical neurology, 119, 541–549. https://doi.org/10.1016/B978-0-7020-4086-3.00035-7

Poorman GW, Moon JY, Wang C, Horn SR, Beaubrun BM, Bono OJ, Francis AM, Jalai CM, Passias PG. Rates of Mortality in Lumbar Spine Surgery and Factors Associated With Its Occurrence Over a 10-Year Period: A Study of 803,949 Patients in the Nationwide Inpatient Sample. Int J Spine Surg. 2018 Oct 15;12(5):617-623. doi: 10.14444/5076. PMID: 30364742; PMCID: PMC6198620.

Weinstein, J. N., Lurie, J. D., Olson, P. R., Bronner, K. K., & Fisher, E. S. (2006). United States trends and regional variations in lumbar spine surgery: 1992-2003. Spine (Philadelphia, Pa. 1976), 31(23), 2707–2714. https://doi.org/10.1097/01.brs.0000248132.15231.fe