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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.
Feel free to share your questions, thoughts and experiences in the comments below, and don’t forget to connect with us on Facebook for more updates and tips on improving your health. We’d love to hear your opinions on who you consider the best Toronto chiropractor.
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)
Dr. Ken, has been recognized as the Best Toronto Chiropractor in 2024, 2023, and 2018, here in downtown Toronto. As a sports chiropractor, he excels in treating a wide range of conditions including concussions, temporomandibular joint disorders (TMJ), sports-related injuries, and spinal issues. Beyond his clinical skills, Dr. Ken is an accomplished athlete, having represented Ontario in the Canadian Judo Championships and completed the Toronto Marathon on two occasions. He employs the innovative C3 Program to provide targeted and effective care to his patients, ensuring a holistic approach to their well-being and athletic performance.
I had an MRI 6 mos ago which showed multilevel bilateral foraminal stenosis and central canal stenosis. Epidural injection did not help and PT made the numbness and pain worse. I had a repeat MRI last week. It was perfect….no stenosis at all. My doctor said she didn’t know why but was glad we didn’t do surgery. I still have symptoms. What is going on?
Hi Dr. Ken, I’ve been told through a CT scan that I have: a broadbased disc bulging with mild retrolisthesis in L1/2 and with a mild canal stenosis, will light excerises help me or not. Also had lumbar fusion 2 years ago, have degenerative diesease, no cartilage between the joints, can someone like you help me and if so, who do you recommend for me to see someone in Melbourne, I live in Reservoir and also is there a cure for what I have! I sincerely thank you for taking the time to reply to my queries.
Author
Thanks for your questions Josie. While you have a lot going in your MRI including the previous fusion surgery, you have to remember a fact. Most people have a lot going on in their MRI with no symptoms at all. https://www.bodiempowerment.com/mri-ct-scan-x-rays/
Basically, in this article, I talk about the fact that most MRI results are not clinically relevant. In other words, they are not causing any symptoms. While you may have mild canal stenosis, it is very unlikely to be causing you pain. Now if I examined you I may change my mind and find that is the reason for your pain but until an examination and history correlate to your actual symptoms then that is the only time you will attribute MRI findings to pain. The problem is that in the world of MRI many health practitioners will diagnosis by MRI and not the other way around. This is an opinion and not a recommendation.
Hope that helps your spinal stenosis.
HI There. I have been diagnosed with spinal stenosis. lumbar herniated disc, i keep getting several slipped disc, and scoliosis. I the cortozone shots use to work, but now they don’t, this doctor in dunville ont. said there is no cure, and that it is too late for any surgery, i am in and out of wheel chairs and can no longer live like this, there must be something that can be done. thankyou colleen dawson
Author
Thanks for your question Collen. Usually the spinal stenosis is not actually causing the pain and it’s the disc herniation with the stenosis being the aggravating factor. Often doing the exercises for the disc herniation helps. However I cannot say in your particular case. You can do these exercises but they may make you worse so they need to be supervised by a health professional. https://www.bodiempowerment.com/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/
You cannot do the exercises without supervision for many reasons.
Hope that helps your slipped disc and spinal stenosis.