SMT & Electrical Dry Needling for Lumbar Spinal Stenosis
Apr
Lumbar spinal stenosis can be a progressive, debilitating condition, but is often amenable to chiropractic care and other conservative treatments…this week, a randomized trial looking at the addition of SMT and electrical dry-needling to conventional physical therapy in a randomized trial.
Lumbar spinal stenosis (LSS) is a narrowing of the spinal canal which can result in compression of the neurovascular structures within the canal and cause pain, cramping, and weakness of the lower extremities that is worsened with standing, walking, and lumbar extension. LSS typically develops because of degenerative changes associated with aging and is the most common reason for spinal surgeries among patients over 65 years-old in the USA.
Common LSS treatments include physical therapy (PT), spinal manipulation, medication, steroid injection, and spinal decompression surgery. However, medication and injections only provide temporary relief and the evidence supporting these treatments for LSS in the long-term is limited. Spine surgery appears to be effective in select LSS patients who fail to improve with conservative care, although long-term patient satisfaction is lacking. Exercise and spinal manipulative therapy have been shown to be effective in the treatment of patients with LSS. However, research in support of electrical dry needling (DN) for these patients is very limited.
No studies have compared conventional PT (CPT), comprising non-thrust spinal/extremity mobilization, exercise, and electro-thermal modalities, with CPT plus electrical DN and thrust spinal manipulation (MEDNCPT) in patients with LSS. The purpose of this study was to compare the effects of these treatment bundles on pain and disability, with the hypothesis that the MEDNCPT group would show greater improvements than the CPT group
From Dr. Thistle:
The findings of this study reiterate recent clinical guideline recommendations for LSS, which emphasize a multimodal approach including manual therapy and rehabilitation. These results also remind us that seeing benefit with care for these patients can take some time. Remember, LSS is a chronic condition, so communicating effectively with patients about progress expectations is important!
RESEARCH REVIEW: SMT & Electrical Dry Needling as Adjuncts to Physical Therapy in Lumbar Spinal Stenosis
This paper was published in the Spine Journal (2023)
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