Lower Back Spinal Stenosis: Is Your Treatment Right or Wrong?
Did you have an MRI telling you that you have a disc herniation or spinal stenosis (pinching of the nerve)?
Is your chiropractor or physiotherapist treating you for spinal stenosis found on your MRI or X-ray.
Your chiropractor or physiotherapist might be treating the wrong thing. A surprising number of chiropractors, physiotherapist and medical doctors believe the MRI and X-ray reports more than their own findings. Most of them allow these reports to influence your treatments. You probably believe your health practitioner too especially when you can actually see the nerve being pinched on the MRI. Why wouldn’t you believe what you can see?
What you see is not always true for spinal stenosis.
What is stenosis? Stenosis is the abnormal narrowing of part of the body. There are two types of stenosis as it relates to the lower back.
Lateral stenosis is the narrowing of the opening for the nerve that comes out from the spinal cord between two vertebrae.
Spinal Stenosis is the narrowing of the opening where the spinal cord sits from the brain right down to the bottom of your spine. If you have lumbar spinal stenosis, you have narrowing of the opening where your spinal cord sits in the lower back.
So why can’t you always trust what you see on MRI for Stenosis? Research shows that what you see on MRI doesn’t relate to the examination by your health practitioner for stenosis..
This means your chiropractor may diagnose you with spinal stenosis, and when you check your MRI you have don’t have spinal stenosis. On the other hand your physiotherapist might say to you that you don’t have a pinched nerve only to discover that you have spinal stenosis.
So who should you believe than? The health practitioner or the MRI.
Your health practitioner: they should correlate the finding of your MRI with their clinical examination. This still doesn’t guarantee results. Then your chiropractor should give you specific goals for your possible stenosis then treat you for it. If it’s not working after 3-4 weeks then change the treatment for another possible diagnosis for another 3-4 weeks.
What Works For Spinal Stenosis?
Conservative treatment that works includes therapeutic exercises, combined epidural steroid injections which seems to have lasting effects up to 3 years. For those with severe stenosis, surgery is the most common and helpful for most people.
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1. Haig AJ et al, Archives of Physical Medicine & Rehabilitation 2006; 87: 897-903.
2. Simotas AC, Dorey FJ, Hansraj KK, Cammisa F Jr. Nonoperative treatment for lumbar spinal stenosis. Clinical and outcome results and a 3-year survivorship analysis. Spine (Phila Pa 1976). Jan 15 2000;25(2):197-203; discussions 203-4. [Medline].
3. Nonoperative treatment for lumbar spinal stenosis. Clinical and outcome results and a 3-year survivorship analysis. Spine (Phila Pa 1976). 2000; 25(2):197-203; discussions 203-4 (ISSN: 0362-2436)
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