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After Treating Hundreds of Patients: What to Consider Before Undergoing Lumbar Spinal Stenosis Surgery

After Treating Hundreds of Patients: What to Consider Before Undergoing Lumbar Spinal Stenosis Surgery

Dr. Michael Derry, DPT, PT, OCS Jacksonville, Florida
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Surgery for lumbar spinal stenosis can feel overwhelming. It is spine surgery and there are some things that I feel my patients really enjoy knowing before making their final decision on whether they are going to have surgery or not. Not only is important to understand your need for surgery, but it is imperative you have the right team around before and after your surgery to help you recover! Let me explain more.

Understanding Lumbar Spinal Stenosis and the Need for Surgery

Lumbar spinal stenosis is a condition that affects the spinal canal in your lumbar region, leading to discomfort and limiting mobility. When the spinal canal narrows, it can cause nerve compression. There are two different treatment paths that you can choose to help spinal stenosis. These two treatment paths are categorized as either conservative or surgical treatments.

If you're struggling with lumbar spinal stenosis, you may find relief through various methods that aim to reopen your spinal canal. Surgical options can provide significant relief for spinal stenosis when conservative measures, like physical therapy, don't yield the desired results. Seeking professional advice can help determine whether surgery to address the spinal issue is right for you.

5 Important Considerations Prior to Spinal Stenosis Surgery

When you’re grappling with the discomfort of spinal stenosis, the decision to pursue spinal stenosis surgery can be a pivotal point in your journey towards pain relief. If you're considering surgery, it's vital to weigh how spinal stenosis surgery could help reduce spinal stenosis symptoms with your unique health profile in mind. Each case of spinal stenosis is as distinct as the spinal anatomy it affects. Whether surgery should be considered hinges on various factors, including the severity of your pain and the specific characteristics of the spinal issues at play. Entrusting your care to the expertise of a surgeon can be a formidable step in reclaiming your vitality. Let's explore 5 things you should consider before you choose spinal stenosis surgery.

considerations before spinal stenosis surgery
Considerations before Spinal Stenosis Surgery

1. Do you actually have spinal stenosis? 

Spinal stenosis is a reduction of space in your spine. The most common symptoms being leg pain when walking. You may feel back pain from this diagnosis as well.

What is important to consider is that you may have spinal stenosis based on a diagnostic image, like an MRI, but what we really want to know is how are you functioning in your day to day? I see so many clients with "stenosis"without any pain or limitation.

This is important before you choose invasive treatments like surgery. You can fix spinal stenosis without surgery. Physical therapy is the ideal and evidence supported starting point for if you are looking for spinal stenosis relief. You always want to start conservative.

2. What do Injections do? 

Injections can be used as a diagnostic tool to understand where exactly your spinal stenosis is. The physician will do the injection right at the nerve they think is causing you pain. If you feel relief from the leg pain, it might be a good indicator that surgery might be a good option for you! Many times this is a sure fire way to determine if you are a good candidate for spinal stenosis surgery.

3. What to do before and after spinal stenosis surgery? 

Before surgery, it is imperative to establish a relationship with a physical therapist. Ideally, you should try to see them for several weeks before surgery to strengthen your muscles before you undergo the procedure. This is to ensure that you already have a good foundation to come back to after your surgery. After surgery, you should reach back out to the physical therapist you were seeing before and continue working with them to continue building muscle and gaining resiliency!

4. What are the risks to spinal stenosis surgery? 

With any surgery, there are risks involved. One of the main risks with spinal stenosis surgery is that you could increase your likelihood of having more surgeries in the future. It is important that you know the statistics on this before you choose to go through with surgery because we obviously do not want you to have more procedures than you need. Although it is a lower risk surgery, there is still a chance you may have to go through it again just to get more relief.

5. Does spinal stenosis surgery work? 

Spinal stenosis absolutely works for the right person! If you have thought through all of the above considerations and thought "Yes! That is me!" then you are likely a good candidate for spinal stenosis surgery. And I have seen many success stories from these procedures. One thing that I notice a lot in my clients when I visit them after their surgery is the first time they stand up, they have immediate relief from their leg pain.

Another thing that is surprising for my clients is how quickly they are able to get up and start walking again. Spinal stenosis surgery works, just make sure its right for you!

The Role of Physical Therapy in Managing Spinal Stenosis Without Surgery

When considering how to manage lumbar spinal stenosis, it's essential to recognize that surgery isn't your only avenue. Physical therapy can play a significant role in managing spinal stenosis non-surgically, helping to reduce symptoms and improve your spine's health. Through individualized treatments, physical therapy can often alleviate the back pain associated with stenosis effectively. I have been a physical therapist for almost a decade and I have seen many clients do well with physical therapy for spinal stenosis pain relief. Specific and personalized exercises that are designed to strengthen your back will be incorporated in your care and are vital to ensuring you are getting the relief you need - without having to go under the knife.

What to Expect from Spinal Stenosis Surgery: A Surgical Perspective

When considering spinal stenosis surgery, particularly a laminectomy, it's crucial to understand what the procedure entails for your spine.  During surgery, a portion of the bone that’s putting pressure on your spinal nerves is removed, potentially restoring your health and mobility. Discussing minimally invasive options with your surgeon is important, as these can lead to a quicker recovery. It’s vital to have a clear picture of the surgery’s benefits and risks, to ascertain if it's the right step towards pain relief. Remember, surgery isn't the only path! Conservative treatments, like physical therapy, is readily available for you and can be an essential part of managing pain caused by spinal stenosis.

How to Choose the Right Clinic for Your Spinal Stenosis Surgery

When considering surgery for lumbar spinal stenosis, selecting the right clinic is crucial for your health and the spine's well-being. Ensure the clinic's spine surgeon is experienced in surgical treatments specific to lumbar spinal stenosis. Communicate openly with your primary provider about the implications of surgical versus non-surgical approaches. Look for a clinic that integrates surgical expertise with a holistic understanding of health, considering your spine's unique needs. Always choose a clinic that resonates with your health expectations, emphasizes pain relief, and has a reputable spine surgeon aligned with your healing journey.


Q: What is lumbar spinal stenosis, and how can Revision Health Services help?

A: Lumbar spinal stenosis is a condition where the spinal canal in your lumbar region narrows, causing discomfort and limiting mobility. At Revision Health Services, we offer a range of treatments, both conservative and surgical, to help alleviate your pain and improve mobility. Our team of dedicated professionals is committed to understanding your specific needs and guiding you through personalized care plans to enhance your well-being.

Q: Can physical therapy effectively treat lumbar spinal stenosis?

A: Absolutely! Physical therapy is a potent non-surgical treatment option for managing lumbar spinal stenosis. The specialized physical therapists at Revision Health Services can help you strengthen your spine and alleviate back pain with targeted exercises and stretches crafted to your individual condition, often reducing the need for surgery.

Q: Is spinal stenosis surgery necessary for everyone suffering from this condition?

A: Not necessarily. The necessity of surgery for spinal stenosis varies based on the severity of symptoms and individual health profiles. At Revision Health Services, we explore all treatment avenues, considering non-surgical options like physical therapy as viable alternatives. Surgery is typically recommended only when conservative measures fail to provide significant relief.

Q: What does spinal stenosis surgery entail, and what are my options at Revision Health Services?

A: Spinal stenosis surgery, such as a laminectomy, involves removing a portion of the bone that is compressing the spinal nerves to relieve pain. At Revision Health Services, we discuss and consider both traditional and minimally invasive surgical options, always aiming for the quickest recovery and best outcome tailored to your needs and health goals.

Q: How do I decide between surgical and non-surgical treatments at Revision Health Services?

A: Decision-making for treating lumbar spinal stenosis involves a thorough evaluation of your condition and a comprehensive discussion with our spine specialists. We at Revision Health Services ensure that you are fully informed about the pros and cons of all your options, weighing the effectiveness of physical therapy against the potential benefits of surgery for your unique spine health and lifestyle. Together, we will tailor a plan that prioritizes your well-being and provides you with the support needed every step of the way.Remember, Revision Health Services is here to support and guide you through your journey to a pain-free, active life. Our goal is to help you regain control and improve your quality of life with the best possible care for your spine health.


  1. Katz JN, Zimmerman ZE, Mass H, Makhni MC. Diagnosis and Management of Lumbar Spinal Stenosis: A Review. JAMA. 2022 May 3;327(17):1688-1699. doi: 10.1001/jama.2022.5921. PMID: 35503342.

Dr. Michael Derry is a Doctor of Physical Therapy and board certified in orthopedics. He is very passionate about treating lower back pain and helping people build their resiliency. He has spent time assisting at universities as well as managing large clinics before starting his own practice in Jacksonville, FL.

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