Back surgery is a much-used method for treating lumbar spinal stenosis; in the US, the disease is the most common reason for back surgery among older people. Meanwhile, there is a lack of evidence on the effect of nonsurgical treatment of lumbar spinal stenosis.
Accordingly, a group of American researchers carried out a randomised clinical trial, where they aimed to study and compare the clinical effect of three nonsurgical interventions for patients with lumbar spinal stenosis, medical treatment, group exercise and manual therapy/individual exercise.
The researchers conclude that a combination of manual therapy/individualized exercise provides greater short-term improvement in symptoms and physical function and walking capacity than medical care or group exercises, although all 3 interventions were associated with improvements in long-term walking capacity.
The study was carried out as a three-part RCT over the course of three years. 259 participants in the study, who were all over 60 years old, and had lumbar spinal stenosis, were randomly divided into three groups, one group for each intervention. For six weeks they received two weekly interventions with their assigned intervention. After the intervention, the participants went for controls two and six weeks after their intervention had been completed.
All three interventions showed a positive effect at the 2-month control, but a greater share of the patients reacted positively on symptoms, physical function and walking capacity after receiving manual therapy/individual exercise than after medical care or group exercises. There was no difference between the average outcome or response rates in the groups at the 6- month control. The exact numbers and a more thorough description of the study can be found in original paper in the link below.
The study was carried out by Michael J. Schneider, Carlo Ammendolia, Donald R. Murphy, Ronald M. Glick, Elizabeth Hile, Dana L. Tudorascu, Sally C. Morton, Clair Smith, Charity G. Patterson, Sara R. Piva (see titles and affiliations in the original paper).
Schneider MJ, Ammendolia C, Murphy DR, et al. Comparative Clinical Effectiveness of Nonsurgical Treatment Methods in Patients with Lumbar Spinal Stenosis: A Randomized Clinical Trial. JAMA Network Open 2019. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2720073