Posts tagged spine surgery
High recurrence of back and leg symptoms found after lumbar disc surgery

Previous research has shown an improvement and regression of lumbar disc injuries with conservative treatments including Physical Therapy.  Based on clinical practice guidelines and the available evidence, few patients with back and leg pain require surgical interventions for a lumbar disc injury.  Many who pursue surgical intervention seek relief of their associated leg symptoms, but until now it was not known how many of these patients either find relief of their pain or experience recurrent leg symptoms.

An article in the journal Spine examined patients who underwent lumbar disc surgery to determine their rates of pain resolution or pain recurrence at both 1 and 3 year follow ups (Suri et al. 2017).   The authors reported a significant risk of leg pain recurrence among the surgically treated patients with a 20% and 45% risk of leg pain recurrence at 1 and 3 year follow up, respectively.  Patient's who reported initial resolution of leg pain symptoms after surgery demonstrated significantly less symptoms than those who did not have resolution of their pain.  The authors concluded recurrence of both leg and back pain is common after discectomy.

For the majority of patients with back and leg pain, conservative treatments such as Physical Therapy should be utilized before surgical consultation. 

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Lumbar Spinal Stenosis Physical Therapy vs. Surgical Interventions
lumbar spinal stenosis, physical therapy interventions, surgery

Lumbar Spinal Stenosis is a spinal diagnosis found in older adults and involves a narrowing of the canals in which the nerves exit the spine.  It can be found in either the central canal of the spine or in the foramen where nerves exit on each side of the spine.  Often these patients reports symptoms of back and leg pain, pins and needles, numbness, or leg weakness.  Lumbar spinal stenosis is the leading cause of lumbar surgery in the U.S. but non surgical Physical Therapy interventions including manual therapy, exercise and body weight supported treadmill have been shown to have a positive impact on pain and disability in this population (Whitman et al. 2006). 

A recent study in the Annals of Internal Medicine (2015) by Delitto et al. compared the impact of surgery to non surgical treatments for patients with lumbar stenosis.  169 patients were randomly assigned to either a surgical or Physical Therapy group and were followed for 2 years.  Authors reported surgical decompression had similar effects to a Physical Therapy treatment program for patients with lumbar stenosis.  Try a manual physical therapy approach to reduce your pain, improve your function, and avoid the unnecessary cost and risks of spine surgery. 

Lumbar stenosis, surgery, physical therapy interventions