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Lumbar spinal stenosis in Brooklyn usually announces itself the same way: leg pain, cramping, or heaviness that kicks in when you stand or walk and eases when you sit or lean forward. So can a chiropractor help? Sometimes, as one part of conservative care. The evidence has improved in recent years, but it comes with caveats you should hear before you book anything.
(Narrowing in the neck is a different problem. See our page on cervical spinal stenosis.)
Key Takeaways
- Lumbar spinal stenosis is a narrowing around the nerves in your low back. Symptoms often show up in the buttocks and legs, not just the back.
- A 2022 systematic review found moderate-quality evidence that manual therapy combined with exercise helps. Its 2013 Cochrane predecessor found the evidence too weak to recommend any specific treatment.
- Several authors of that 2022 review report funding from chiropractic research foundations, so more independent trials would help.
- New bladder or bowel changes, numbness in the groin, or leg weakness that’s worsening fast are emergencies. Go to the ER, not an appointment.
What lumbar spinal stenosis feels like
The classic pattern, per a BMJ clinical review: pain in the buttocks or legs, with or without back pain, that gets worse with standing, walking, or leaning backward and eases when you sit, lie down, or bend forward.
Stenosis also shows up on scans of plenty of older adults who feel fine. The same review points out that high rates of narrowing on imaging in people with no symptoms make the condition hard to study and hard to diagnose from a picture alone. Your symptoms and your exam count for more than the report. We cover that in our guide to imaging before a chiropractor visit.
Can a chiropractor help with lumbar spinal stenosis in Brooklyn?
It can be a reasonable thing to try. Nobody can promise it will work for you.
Here’s how the evidence moved. A 2013 Cochrane review of nonoperative treatment for stenosis with neurogenic claudication found the evidence too weak to recommend any specific approach. The 2022 update added 23 new trials. It found moderate-quality evidence, from three trials in total, that manual therapy plus exercise gave better short-term symptom and function results than medical care or community group exercise, and that manual therapy, education, and exercise improved walking distance compared with home exercise. Its conclusion: a multimodal approach that includes manual therapy and exercise is effective. Most of the other treatments it looked at still had low or very low-quality evidence.
The caveat. Several of that review’s authors report funding from chiropractic research foundations. That doesn’t make the findings wrong. It’s a reason to want independent trials too.
There’s also an older, smaller study specific to the Cox technique. Murphy and colleagues followed 57 consecutive stenosis patients treated with distraction manipulation (done on a table that moves your lower body through flexion and distraction), neural mobilization, and home exercise. Patients rated their improvement at about 65% by the end of treatment. At long-term follow-up, averaging 16.5 months, 73% had a clinically meaningful drop in disability. Two patients went on to surgery. Twelve had a temporary increase in pain. It had no comparison group, so it can’t prove the care caused the improvement, and stenosis symptoms often change on their own.
What care at Brooklyn Chiropractic Care looks like
Your first visit starts with a consultation and an orthopedic and neurological exam, with digital X-rays if they’re clinically needed, before the first adjustment. That exam is how you find out whether your symptoms fit stenosis, a disc problem, or something else.
For disc-related problems, Dr. Patel uses flexion-distraction, a gentle, hands-on, non-thrusting technique done on a specialized table. It’s the same family of technique used in the Murphy study. Whether it fits your stenosis is something the exam decides. Our flexion-distraction guide explains the technique.
When to see a doctor first
Go to an ER or call your doctor right away for new trouble controlling your bladder or bowels, numbness in your groin or inner thighs, or leg weakness that’s getting worse fast. Those can signal cauda equina syndrome, which is a surgical emergency and not a chiropractic problem.
If symptoms keep shrinking how far you can walk despite a reasonable run of conservative care, ask a spine specialist whether surgery makes sense. The BMJ review notes that surgery is almost always elective and considered when bothersome symptoms persist despite less invasive options.
Frequently Asked Questions
Will I need surgery for lumbar spinal stenosis?
Not necessarily. The BMJ review notes that rapid deterioration is rare and symptoms often wax and wane or slowly improve, which is why surgery is almost always elective. Fast-worsening weakness or bladder and bowel changes are the exceptions and need urgent attention.
Can exercise help lumbar spinal stenosis?
Yes, as part of a package. The 2022 review’s conclusion favored a multimodal approach that includes manual therapy and exercise. Exercise on its own had weaker evidence, so treat it as one piece and not the whole plan.
Is lumbar spinal stenosis the same as sciatica?
No. Stenosis is a narrowing around the nerves. Sciatica is a pattern of leg pain, and stenosis is one of several things that can cause it. Our sciatica page covers the other causes.
Ready to find relief? Schedule an appointment online with Dr. Patel at Brooklyn Chiropractic Care in Greenpoint.
References
- Lurie J, Tomkins-Lane C. Management of lumbar spinal stenosis. BMJ. 2016;352:h6234. PubMed: 26727925
- Ammendolia C, Hofkirchner C, Plener J, et al. Non-operative treatment for lumbar spinal stenosis with neurogenic claudication: an updated systematic review. BMJ Open. 2022;12(1):e057724. PubMed: 35046008
- Ammendolia C, Stuber KJ, Rok E, et al. Nonoperative treatment for lumbar spinal stenosis with neurogenic claudication. Cochrane Database Syst Rev. 2013;(8):CD010712. PubMed: 23996271
- Murphy DR, Hurwitz EL, Gregory AA, Clary R. A non-surgical approach to the management of lumbar spinal stenosis: a prospective observational cohort study. BMC Musculoskelet Disord. 2006;7:16. PubMed: 16504078
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