Spondylolithesis

spondylolisthesis

Spondylolisthesis occurs when one vertebra slips out of place. This slight slippage can sometimes cause compression of the nerves and, in some cases, cause tingling, numbness, pain, and even weakness in the legs.

Spondylolisthesis can be the result of a trauma to the spine, a congenital defect or simply be a progression of osteoarthritis. Spondylolisthesis can occur, without apparent cause, as people age. In younger individuals, spondylolisthesis usually occurs as a result of trauma during sports such as gymnastics or football and can cause a fracture in the vertebra.

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Structures involved

Spondylolisthesis is found in the spine. The​ spine​ is made up of bones called ​vertebrae​ and between them are the ​intervertebral discs,​ which act as shock absorbers. Spondylolisthesis most often affects the lumbar region, particularly the L5 vertebra.

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Signs & Symptoms that you may experience with spondylolisthesis.

Each person will react differently to the presence of spondylolisthesis and symptoms can vary considerably. Initially, spondylolisthesis may be present without any noticeable symptoms.

When pain is present, it is often felt in the lower back or the buttocks. It can range from mild to severe and can affect daily activities such as walking. Burning and tingling sensations may be felt in the area of the buttocks and legs.

Sitting or leaning forward is often less painful than standing or walking because of the positioning of the spine.

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▶​ ​WHAT TO DO

Early Stage

Relative rest is a good way to protect your back and prevent your condition from getting worse, but it is important to avoid over-protecting it. A temporary reduction in activity may be necessary, but a quick return to your daily activities, light cardiovascular exercise and specific strengthening and mobility exercises will allow for better recovery.

Rehabilitation

Follow your therapist’s advice. This will help you manage your symptoms and increase the chances of successful rehabilitation. Your therapist will accompany you during your rehabilitation program to restore your mobility, muscle strength and endurance, flexibility and functional status.

According to the principles of spondylolisthesis rehabilitation, the reduction of joint and muscle stresses in the lumbopelvic-hip complex (back, pelvis, hip), the improvement of posture and thoracic mobility, muscular balance and weight control would be important elements for a functional recovery.

A progressive training program over a period of a few weeks including education on load-lifting techniques is quite common.

▶ ​WHAT TO AVOID

Do not rely solely on a passive treatment approach. Patients who actively participate in their treatment plan tend to better manage the symptoms caused by spondylolisthesis. Remember that pain is not always a good indicator of tissue damage. As soon as you feel better and the pain is well under control, introduce, in collaboration with your therapist, mild strengthening, mobility and cardiovascular exercises based on your tolerance.

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Chiropractic: Obesity, Smoking, & Drinking Associated with Low Back Pain.

SMoking and back pain
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Chiropractic: Obesity, Smoking, & Drinking Associated with Low Back Pain.

New research presented at the American Academy of Orthopedic Surgeons annual meeting suggests that low back pain sufferers who smoke, drink, and/or are obese may possibly ease their agony by making healthier lifestyle choices. A review of data from 26 million men and women found that people who are smokers, are alcohol-dependent drinkers, and/or are categorized as obese are between four and five times more likely to currently experience back pain than individuals who don’t smoke or drink, and maintain a healthy weight. American Academy of Orthopaedic Surgeons, March 2015

Trigger points in the abdominal muscles.

Myofascial trigger points in the abdominal muscles are very common. These muscles are responsible for trunk movement and stability, and are engaged in some way during most activities. As a result trigger points will easily form. These knots will often refer pain into the lower or mid back in a horizontal strip. Trigger points in the abdominal muscles are often overlooked as a source of back pain. Once developed, a trigger point won’t release on its own. A therapeutic modality such as trigger point massage is needed to release the tissue.

Poor posture and trigger points

If this looks familiar to you, then you probably have trigger points. The muscles in your back and neck become strained and overloaded and the muscles in the front become shortened and contracted. When this happens trigger points can develop. These points will cause pain, refered pain, stiffness and weakness. Trigger points in the neck muscles can refer pain into the head and cause headaches.

Trigger points in the erector muscles.

The erector spinae muscles are a group of muscles the travel the length of your spine. They are responsible for spinal movement and stabilization. These muscles often become overloaded with poor posture of the spine. As a result trigger points often form. These points can cause pain to be felt anywhere along the spine and back. Some of these points can even refer pain into the front abdomen as well

Trigger points in the abdominal muscles.

The Abdominal muscles what people think of as your six pack muscles. They are mostly responsible for flexing the spine and postural stability. These muscles are often tight in people with poor posture with a rounded spine. This causes trigger points to developed. Trigger points in the abs cause pain to be felt in the abdomen, but also frequently in the back. Trigger points in the upper abdominals refer pain into the mid back, and points in the lower abdominals produce lower back pain.

Trigger points in the rhomboids

The rhomboids are muscles between your shoulder blades that are mainly responsible for pulling your shoulder blades back. Poor sitting posture with the shoulders slumped and rounded forward causes these muscles to become strained and overloaded. When this happens trigger points can form, causing achy pain and restlessness between the shoulder blades.

Trigger points and back pain.

Low back pain can be a complicated condition. Quite often in my practice I will see multiple muscles involved in causing lower back pain in my clients. For example trigger points in the hip flexors like the psoas muscle, along with trigger points in the back muscles themselves, such as the quadratus lumborum or the multifidus, can all be active and refer pain into the low back. When trigger points are active in multiple muscles at once this is called a chronic myofascial pain syndrome.