Exercise Therapy
Exercise Therapy vs. Surgery
| Factor | Exercise Therapy | Surgery (Decompression) |
|---|---|---|
| Short-term results | Somewhat slower improvement | Faster initial improvement |
| Results after 2 years | Comparable improvement | Stable improvement |
| Risk | Very low (mild muscle soreness at most) | Surgical risks apply |
| Cost | Low | High |
| Best for | All but the most severe cases | Severe cases or when conservative treatment fails |
From the guideline commentary:
A 2015 study reported that exercise therapy and surgery showed comparable improvement at the two-year mark. However, severe and mild cases showed different treatment responses — surgery is better suited for severe stenosis.
Exercise therapy is low-risk and low-cost, making it a worthwhile first-line treatment for all but the most severe cases.
Combining Exercise with Other Treatments
Exercise therapy is effective on its own, but it can also be combined with other treatments:
- Epidural steroid injection + exercise therapy — The injection improves physical function; adding exercise further enhances quality of life (emotional and mental well-being)
- Exercise therapy + ultrasound therapy — Exercise improves pain and function; adding ultrasound can reduce the need for pain medications