As the general population ages, so will our patients. This means we will all see more elderly patients in our offices in the years to come, many of whom may present with Lumbar Spinal Stenosis (LSS), which is caused by age-related degenerative changes and is a leading cause of pain, disability and loss of independence. These degenerative changes lead to narrowing of the spinal canal, resulting in compression and diminished blood supply to spinal nerve roots. Clinically, this presentation is termed neurogenic claudication, presenting with symptoms of lower extremity pain, the sensation of heaviness, numbness, tingling or weakness with standing or walking. A defining characteristic of LSS is that symptoms are typically relieved by sitting and bending forward. Limited walking ability is the dominant functional impairment for patients with LSS and may lead to a progressive decline in health. It is also the most common reason patients seek care and is also associated with increased levels of depression, anxiety and hopelessness. It is also important to remember that the natural history of LSS suggests no significant improvement in walking ability over time.

LSS is the most common reason for spinal surgery in older adults. However, most patients are managed non-surgically, despite the fact systematic reviews of non-surgical management suggest unproven benefit for improving walking outcomes.

This randomized control trial was designed to compare the effectiveness of a structured, comprehensive, conservative treatment program with a focus on self-management and improved walking ability (including exercise, education and manual therapy, specifically lumbar spinal manipulation) to a self-directed program in improving walking ability in patients with neurogenic claudication due to LSS…the results are very supportive of an approach chiropractors are perfectly positioned to employ! LOG IN OR SUBSCRIBE TO ACCESS THIS RESEARCH REVIEW!
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