Many people have Spondylolisthesis and do not even know they have it! Sometimes this medical condition can be present in the spine and the person does not have any symptoms or pain. The only way to diagnose Spondylolisthesis is by x-ray, CT or MRI scans. Spondylolisthesis is the medical terminology used when one vertebra slips out of place onto the vertebra below it. This condition of the vertebra can be mild or severe. When the symptoms do begin, the pain is usually in the lower back region. It can often feel like a muscle strain. Other people sometimes experience muscle spasms that involve the hamstring muscles in the thighs. If the vertebra is pressing against a nerve, the lower back pain can also radiate down the legs and even involve the feet. It can also cause the tingling and numbness often associated with nerve problems.
I have been living with Spondylolisthesis for more than twenty-five years. I am fortunate that my legs are not affected by my slipped vertebra, although the pain does radiate into my hips and buttocks occasionally. There are strengthening and stretching exercises which help me to manage my pain. For myself, what not to do is just as important. For instance, I love to garden and work in the yard and I know I will pay the consequences for a couple of days. Any strenuous bending and stooping will aggravate my symptoms and worsen the pain. Lifting must be done by bending the knees and not the back. This is the correct way anyone should lift heavy items anyway. I also cannot sleep on my stomach or my back. I must sleep on my side with a pillow placed between my knees and thighs. This really lessens the strain on the vertebra, resulting in less pain and spasms in the lowest part of my back.
The exercises and stretches that I was taught in physical therapy a long time ago have proved to be valuable tools for managing my Spondylolisthesis. I can’t over emphasize the important role of the abdominal muscles have in managing this painful condition. To live with Spondylolisthesis requires keeping the abdominal muscles strong. I really think this has been the main reason I have been able to live with this condition for such a long time. The vertebra is slipping inward and when the abdominal wall is taunt, it actually helps to ease the pain and automatically keeps the spine aligned at a comfortable position. I pull my stomach muscles in as tight as possible whenever I do any physical activity, it actually feels good to my lower back and helps to lessen any further damage at the same time.
Someone suffering with Spondylolisthesis cannot obviously do as much strenuous exercise and must take care when strengthening the stomach muscles. Lying flat on the floor should never be done without the knees bent and the spine pushed flat against the floor. This is actually one of the stretching exercises used in physical therapy for Spondylolisthesis. It feels wonderful to my back. I always keep my feet flat on the floor and my knees bent. I then pull my abdominal muscles tight while pushing my spine flat against the floor. I hold this position for several seconds and release my abdominal muscles and repeat, pushing the spine flat each time. This is also the time to do modified stomach crunches or sit-ups, but this should never be done without the knees bent for a Spondylolisthesis patient. I recommend consulting your doctor before doing any new exercise.
There are three main types of Spondylolisthesis. The first type is called Congenital Spondylolisthesis. This means that an abnormality occurred at birth in the formation of the bones of the spine, making the vertebra more susceptible to slipping. Spondylolisthesis is one of the most common reasons for back pain in teenagers. The symptoms begin to manifest after the rapid growth spurt that teens go through. The second kind is Isthmic Spondylolisthesis which occurs from another condition of the spine called spondylolysis. This is when small breaks happen in the vertebra. Sometimes this condition can stress the bone enough to cause slippage. Degenerative Spondylolisthesis is the third type and occurs with aging. It is also the most common type found in adults. The discs between the vertebra naturally wear and become less spongy. This condition is degenerative, much like arthritis. When the discs begin to wear out, Spondylolisthesis can occur.
There are other types of Spondylolisthesis that are less common. One of these is from a spinal injury and is called Traumatic Spondylolisthesis. This is the type I have. The particular injury that I had commonly causes a fractured coccygeal (tail) bone. Instead it caused small fractures in the bones beside the lower vertebra and enabled the vertebra to begin moving forward. Another type called Pathological Spondylolisthesis can happen when the spine is weakened from an infection, a tumor or a disease such as osteoporosis. There is also a type that is called Post surgical Spondylolisthesis. Just as the name suggests, sometimes a spinal surgery can cause the spine to weaken.
Receiving a diagnosis of Spondylolisthesis does not mean the end of having an active and normal life. It will involve lifestyle changes and depending on the severity, can involve pain. I also wanted to note that I did check with a Chiropractor. I was hopeful that this form of therapy could be beneficial. It is not and could be dangerous to the vertebra. I respected and appreciated the honesty I received from the Chiropractor. The pain can be managed and it doesn’t mean the lifelong need for narcotic pain relievers. I do not take them or muscle relaxers. Over-the-counter pain medications, physical therapy, and moist heat keep the pain at a tolerable level for me. It is my hope that if someone suspects this might be the reason for recurring back pain, they will schedule a doctor’s visit and get the necessary tests. Knowing what to do and what not to do can possibly prevent further slippage and keep the condition from worsening, while keeping the pain at a minimum. The web is full of useful information on Spondylolisthesis, but I found a site particularly helpful at the American Academy of Orthopaedic Surgeons. This web site used laymen terms and was not just for the medical professionals as so many sites I visited. The AAOS has several web sites. The one I found helpful in laymen terms with printer-friendly pages is at: http://orthoinfo.aaos.org./main.cfm. You will be on the homepage and can then enter a search for Spondylolisthesis, and the next page will have the article listed first.
