Physical Therapy versus Surgery for Back Pain

Can Physical Therapy for Back Pain be as effective as Surgery?

Yes!  Studies show that physical therapy may be as good as surgery for common back problems and pain.


Surgery Versus Nonsurgical Treatment of Lumbar Spinal Stenosis: A Randomized Trial1

On April 7, 2015, a seven year study published in the Annals of Internal Medicine compared surgical decompression surgery with physical therapy (PT) for lumbar spinal stenosis (LSS), a form of back pain.  The study concluded that, “Surgical decompression yielded similar effects to a PT regimen among patients with lumbar spinal stenosis (LSS) who were surgical candidates.”1

What is Lumbar Spinal Stenosis? “Lumbar spinal stenosis, a compression of open spaces in the lower spinal column, can lead to pinched nerves, tingling, weakness and numbness in the back and the lower extremities.2

The study consisted of 169 patients who chose to participate.  Initially, 87 patients chose surgery and 82 chose to pursue physical therapy.

The group who chose to pursue physical therapy were given rehabilitation twice per week for six weeks.  They were all  allowed to opt out at any point and pursue surgery.  Of the 82 who started with physical therapy, 47 patients (or 57%) opted out after starting physical therapy and pursued surgery.

At two years, the patients did a follow up exam and appointment.  The average outcome was the same for surgery and for physical therapy.  In other words, physical therapy for LSS sufferers was just as efficacious as surgery.

Sometimes surgery is the best option; however, proper conservative treatment can be just as effective.


As an osteopathic physician, Dr James Whitaker believes that the best patient care is a team approach utilizing many different practitioners to best individualize each patient’s health and care. Many times Dr Whitaker is able to help a patient avoid surgery; however, sometimes it is clearly needed and is the best option.  He knows that good rehabilitation can reduce the need for expensive and more invasive surgeries.



1Annals of Internal Medicine Original Research-  Ann Intern Med. 2015;162(7):465-473. doi:10.7326/M14-1420

2Reuters 2015 04 06 Physical therapy may be as good as surgery for common back problem

Posted in Back Pain, Dr Whitaker, Osteopath, Surgery.