• Percuoco K
• Dunaj-Compo M
• Olson M

• Aged
• Female
• Low Back Pain
• Lumbar Vertebrae
• Open Access Document
• Spinal Stenosis

Objective: To discuss the multimodal management of a patient with low back pain and spinal stenosis.

Clinical Features: A 73-year-old female sought chiropractic care for chronic low back pain with unilateral radicular leg pain. Aggravating factors included walking and standing. Alleviating factors included rest, medication, and spinal manipulative therapy. Her previous MRI report indicated marked central canal and mild neuroforaminal stenosis at L4-L5 due to a Grade 1 spondylolisthesis, disc bulging, facet arthropathy, and degenerative disc disease.

Intervention and Outcome: Treatment consisted of high-velocity low-amplitude chiropractic spinal manipulative therapy and repetitive lumbar extension end-range loading exercises for eight visits over eight weeks. A home exercise program of end range loading and walking was prescribed and reinforced. The patient reported resolution of the radicular leg pain and improvement in low back pain. Upon discharge, the Back Bournemouth Questionnaire improved from 33/70 to 11/70 and maintained a 11/70 at a 7-month follow up.

Conclusion: This report presents a patient with unilateral radicular leg pain and spinal stenosis that responded positively to spinal manipulative therapy and lumbar extension end range loading exercises. The results suggest extension exercises may offer some value for those with image-supported spinal stenosis.

Author keywords: Chiropractic; Lumbar Spinal Stenosis; Low Back Pain

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