Comparable Benefits for PT, Surgery in Lumbar Spinal Stenosis
Findings for study participants in their late 60s
TUESDAY, April 7, 2015 (HealthDay News) -- Physical therapy may be just as good as surgery for older adults with lower back pain due to lumbar spinal stenosis, according to new research published in the April 7 issue of the Annals of Internal Medicine.
The investigators focused on 169 patients with lumbar spinal stenosis who sought care in western Pennsylvania. On average, participants were in their late 60s, and none had undergone prior surgery for the condition. All demonstrated similar mobility impairment, and on a pain scale of 1 to 10 all were rated 7 prior to treatment. About half the patients were randomly assigned to undergo decompression surgery between 2000 and 2007. None underwent fusion surgery. The other half was randomly assigned to physical therapy twice a week for six weeks. However, physical therapy patients could switch over to surgery, and more than half of them eventually did so.
Mobility assessments were conducted at the 10-week point, at six months, and one year out. Two years following either surgery or physical therapy completion, patients filled out a survey designed to assess pain, disability and function, symptoms, and expectations. In terms of pain relief and function, there was no long-term difference between surgery and physical therapy, according to the researchers. Not all patients achieved a clinically meaningful level of improvement, but both physical therapy and surgical patients started to see benefits as early as 10 weeks out, with continuing improvement unfolding for both groups over the following four months. Similarly, both groups maintained their improvements equally well through the two-year mark.
"The risks of physical therapy are considerably less, and one would be hard-pressed to consider any of the risks serious," study author Anthony Delitto, P.T., Ph.D., a professor of physical therapy and associate dean of research with the school of health and rehabilitation sciences at the University of Pittsburgh, told HealthDay.