Q: My 83-year-old mother was recently diagnosed with spinal stenosis by her physician. She mostly suffers from back pain and sometimes pain down her leg. She tries to avoid the pain by bending forward most of the time. Would a brace help her?
A: Lumbar spinal stenosis in this age group is usually caused by the natural degeneration or wearing down of the spine over time. The condition is described as a narrowing of the space available for the spinal cord, nerve roots, and blood vessels in the spine to occupy. The lumbar spine (low back area) is the region affected most often by this condition.
Bending forward helps take the pressure off the neural segments (spinal cord, spinal nerve roots), but this compensatory posture has some obvious drawbacks. The use of brace can help decrease the pain in stenotic patients, thus making it possible to stand upright and walk unassisted temporarily. However, once the brace is removed, the benefits are gone as well. In other words, wearing a brace is not a long-term answer.
Other types of treatments (including acupuncture, electrical stimulation, and traction) have been tried and results reported. But not everyone responds well and there is insufficient evidence to direct and guide who is most likely to respond to each treatment type.
Surgery is advised for patients with moderate-to-severe symptoms that persist over time. Keep in mind that patients with mild-to-moderate symptoms have a 30-50% chance of improvement over time without treatment. Symptomatic relief with short-term bracing is considered acceptable, especially if there is a chance for symptoms to resolve without surgery.
Reference: D. Scott Kreiner, MD, et al. An Evidence-Based Clinical Guideline for the Diagnosis and Treatment of Degenerative Lumbar Spinal Stenosis (Update). In The Spine Journal. July 2013. Vol. 13. No. 7. Pp. 734-743.