G'day Uri,
It looks like it, but to make sure: age > 60 years, SLR/Slump -ve,
cough/sneeze/strain/Valsalva manoeuvre -ve? If indeed, there's hope.
From the literature, communication with a chiropractic teacher and personal
experience, I've learned the following:
1. NSAIDs as a short term treatment. All other treatments may take too long
to take effect, and I've even seen a case in which ibuprofen did it all....
(she's now on them no longer, and things are going great, even without me
having done anything else; it seems as if the affected nerve root adapted
itself - she only has some paraesthesias on occasion; she was a clear
stenosis case, if you'd find this hard to believe).
2. Stretching the iliopsoas muscle, in the reciprocal straddle position.
Twice daily, for 30-45 seconds per side. Make sure that the pt. does it
correctly, it keeps doing it correctly: the iliopsoas strain must be felt.
Make sure to do it bilaterally, even if she has only uni complaints.
3. You will need a traction table, but this is the exception in which
(continuous) traction works, according to both the chiro teacher and Dos
Winkel (a 'descendent' from Cyriax), and if I'm transferring the principles
from his ('new') cervical spine book to his (old) lumbar spine book
correctly, also according to McKenzie. In supine lying, with a roll under
the knees, for 40 minutes, with a considerable amount of force (if no severe
osteoporosis, proceed to the maximum force as described by the
manufacturer, if the first treatment has not produced any side effects such
as bruises on the hips from the bands). Do this daily to start with, and
after the first 5 treatments see if complaints stay away for two days. If
so, gradually extend the periods between treatments. If not, continue with
daily treatments until the next weekend, and then again see if complaints
stay away for 2 days.
4. Have her ride a bike in stead of walking, if that's possible. Otherwise,
advise her to have a seat before the pain comes up.
5. Keep us posted.
R.,
Frank Conijn, PT
----- Original Message -----
From: "אורי" <[log in to unmask]>
To: <[log in to unmask]>
Sent: vrijdag 7 september 2001 7:18
Subject: spinal stenosis
Hii world
I have many patients that are suffering from spinal stenosis [intermittent
claudication, loss of ex"', reduce pain in sitting atc' ].
Do you have any suggestions of treatments -manual electro' - or any other
modalities ,because it is very difficult case to
Deal with.
Thanks in advance
Uri Yaros
Israel
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