BACKGROUND: Physical therapy (PT) is commonly prescribed for patients with lumbar spinal stenosis (LSS); however, little is known about its effectiveness. PURPOSE: To systematically review randomized controlled trials (RCT), controlled trials and cohort studies evaluating the effectiveness of PT for LSS. DATA SOURCES: Studies were searched on electronic databases to January 2012. STUDY SELECTION: Inclusion criteria were: clinical diagnosis of LSS with confirmatory imaging, evaluation of PT treatment, presence of a comparison group and outcomes of pain, disability, function or quality of life. DATA EXTRACTION: Outcomes were extracted and when possible pooled using RevMan 5. DATA SYNTHESIS: Ten studies were included: 5 RCTs, 2 controlled trials, 2 mixed design and 1 longitudinal cohort study. Pooled effects of 2 studies revealed that the addition of a PT modality to exercise had no statistically significant effect on outcome. Pooled effects results of RCTs evaluating surgery versus PT demonstrated that surgery was better than physical therapy for pain and disability at long term (2 years) only. Other results suggested that exercise is significantly better than no exercise, that cycling and body weight supported treadmill walking have similar effects, and that corsets are better than no corsets. LIMITATIONS: The limitations of this review include the low quality and small number of studies, as well as the heterogeneity in outcomes and treatments. CONCLUSIONS: We were unable to draw conclusions on which PT treatment is superior for LSS. There was low quality evidence suggesting that modalities have no additional effect to exercise and that surgery leads to better long term (2 years) outcomes for pain and disability, but not walking distance, than PT in patients with LSS.

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A brief summary and a critical assessment of this review may be available at DARE