American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the management for chronic cervical or lumbar stenosis?

1. Surgical intervention alone

2. Only physical therapy

3. Physical therapy and symptomatic management

4. Medication therapy only

The correct answer is: Physical therapy and symptomatic management

The management of chronic cervical or lumbar stenosis primarily involves a multifaceted approach that combines physical therapy with symptomatic management. This method is considered effective because it addresses both the mechanical and symptomatic aspects of the condition. Physical therapy can help improve strength, flexibility, and overall function, which may alleviate some of the symptoms associated with stenosis. Additionally, symptomatic management can include the use of analgesics, anti-inflammatory medications, and other modalities to relieve pain and improve quality of life. This integrated approach allows for both conservative treatment of the symptoms and improvement in the functional capacity of the patient, making it a suitable option for those with chronic conditions. Surgical options might be considered in specific cases where conservative management does not provide relief, but they are not the first line of treatment for all patients with chronic stenosis. Both isolated medication therapy and physical therapy alone lack the comprehensive benefits provided by the combination of both approaches. Thus, the choice that incorporates both physical therapy and symptomatic management is optimal for effectively managing chronic cervical or lumbar stenosis.