Assessing Lower Back Spinal Stenosis: Evaluating the Effectiveness of Your Treatment

Can You Trust an MRI for Spinal Stenosis? What Your Chiropractor May Not Be Telling You

Are you getting treatment for spinal stenosis based on an MRI or X-ray? It might not be as clear-cut as you think. Surprisingly, many chiropractors, physiotherapists, and even doctors put too much faith in imaging results. But what you see on that scan might not always be the full story.

What’s Stenosis Anyway?

Stenosis means “narrowing” of a body part. In the lower back, there are two main types:

• Lateral Stenosis: Affects the small openings where nerves exit the spinal cord.
• Spinal Stenosis: Affects the main canal where the entire spinal cord runs.

Why MRIs Can Be Misleading

See Also: Is An MRI, CT scan or X-ray Best For My Pain

Research shows that MRI findings for stenosis often don’t match what your practitioner finds during a physical exam. [1] This means you could be diagnosed without really having it, or vice versa!

Should I Trust the Scan or My Practitioner?

Your chiropractor or physiotherapist should always combine imaging results with their assessment. However, even then, there are no guarantees. Here’s what to look out for:

• Clear Goals: Your practitioner sets specific targets for your possible stenosis.
• Change if Needed: If treatment isn’t helping within 3-4 weeks, they will explore other potential causes.

What Actually Works for Spinal Stenosis?

• Therapeutic Exercise: Can provide significant relief.
• Epidural Steroid Injections: May offer lasting benefits for up to 3 years. [3]
• Surgery: The most common option for severe cases, and often successful.

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 Research

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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