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Physical Therapy

June 21, 2019

Physical therapy for Lumbar stenosis. It’s interesting, it was within the last six months a year, marvelous paper in Spine, which is a journal that crosses all sorts of different specialties, chiropractic, physical therapy, neurosurgery, orthopedics, physical medicine. The title of the article was to sort of distill it, physical therapy improves walking distances 100%. And when you read this study, it was more interesting because the patients started with a distance of about 100 to 200 feet that they could walk. And if they went to vigorous physical therapy over three to five weeks, they might now be able to get up to from 100 to 200 to 200 to 400. but in our culture, and especially here living in Tucson, Arizona, the difference between walking 100 feet and 400 feet isn’t so much. So even though physical therapy may double the distance, you can walk, you’re still left sort of not doing very well. Physical therapy may help some patients. The problem is is that in big studies, you may have a small number of patients, 5% who do spectacularly with the physical therapy and are virtually cured, but they don’t stand out in the statistical analysis because the sampling is so high. It’s like saying, well, if we didn’t do physical therapy, 200 out of 1000 patients got better. And if we did do physical therapy, 205 patients, well those are is out of a thousand statistically those are even odds of the same thing. It didn’t stand out. So it doesn’t show up as being significant, in other words, making a difference. But for those five patients, maybe big deal. So physical therapy, not so good perhaps, but especially for a patient who has a lot of medical problems and remembering that lumbar stenosis, as we talked about earlier in this is a disease, mostly people in their fifties sixties seventies eighties nineties they may have a lot of things going on medically, and certainly physical therapy has very low risk associated with it the majority of the time.

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