Jeff LangmaidFounder, The Evidence Based Chiropractor

Which Stenosis Patients Actually Get Better?

16 Apr 2026 · 1 min

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In this video, Jeff Langmaid critiques the longstanding uncertainty around which spinal stenosis patients benefit most from non‑surgical care. He outlines the range of conservative modalities—manual therapy, movement‑based care, progressive exercise, and lifestyle guidance—and emphasizes that patient responses are highly heterogeneous: some improve rapidly, others plateau, and some fluctuate over time. Langmaid highlights a 2025 research study that begins to stratify stenosis patients into sub‑groups with distinct prognostic profiles, offering the first concrete clues about who is most likely to respond favorably to conservative treatment.

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This is the part that really bugs me. We've known for a long period of time that non-surgical care works for a lot of patients that have stenosis. Manual therapy, movement-based care, progressive exercise, lifestyle guidance. But we haven't been great at answering what I'll call the billion-dollar question, which is who are the patients in that group that actually respond best? Because not every stenosis patient is exactly the same. Some get better really quickly, some stall out, some ebb and flow, some need more time, some need more or less of the various modalities and services that you offer in your practice. So this study, which came out in 2025, finally starts to give both of us some real answers.