My 82-year old mother has been limping along (literally) with spinal stenosis for 10 years now. It’s gotten much worse in the last year. Should we encourage her to have the surgery her doctor is recommending?

Spinal stenosis is a narrowing of the space around the spinal nerves in the low back area. Pressure on the nerve tissue can cause disabling back pain and other symptoms in older adults.

Newly published research shows that moderate spinal stenosis can be treated effectively with nonoperative care. Moderate stenosis was defined as back pain that travels down into the buttocks and leg(s). Some patients had a loss of sensation in the legs. Symptoms were made worse by walking.

In this study, nonoperative care included pain relievers and exercises. The exercises were prescribed and supervised by a physical therapist. When a six-month trial of nonoperative care was unsuccessful, surgery was advised.

The surgical group made better progress at first. But after two years, the exercise group and the surgical group had similar results. The decision to have surgery for this condition should be made after at least a six-month trial of conservative care.

Surgery may still be needed and a valuable tool to reduce pain and disability even in the short term. A two-year reprieve from painful symptoms and loss of function in an 82-year old adult may be worth having the surgery.