If you’re experiencing some type of back pain, you’re not
alone. Back pain is one of the most common medical problems. According to
research, 80% of American population will experience back pain at least once in
their lifetime. Back pain can range from dull, constant ache to a sudden, sharp
pain. Most back pains are not that serious and can be resolved with home
remedies, especially those caused by muscle tightness and muscle fatigue.
However, if you’re experiencing a chronic pain, your back pain can be a signal
of a more serious underlying medical condition, like spondylolisthesis.
In about 5% of
the adult population, a crack develops in one of the vertebrae and may later
develop as a stress fracture. Due to the constant forces in the lower back,
this fracture doesn’t heal like a normal bone. This stress fracture is called
spondylolysis. Now, if the stress fracture is left untreated, it might fully
separate, causing one vertebra to slip forward over the vertebra below it. Once
the slippage occurs, this condition is called spondylolisthesis, or more
commonly known as a “slipped disc.” This slippage is most common at the point
where your fifth lumbar vertebra connects with your sacrum due to the downward
pull of gravity. Because the stress fracture occurs before the forward slippage
of the vertebral body, spondylolysis is generally a precursor to
spondylolisthesis.
Causes of Spondylolisthesis
There are five main types of spondylolisthesis, each with a
different cause. Spondylolisthesis can be caused by:
- a birth defect in the formation of part of the vertebra called the facet. This is called the dysplastic spondylolisthesis which can cause the vertebra to slip forward.
- repetitive stress to the lumbar spine. This results in defect developing in the vertebra, particularly in pars interarticularis, which causes it to slip. This is called the isthmic spondylolisthesis and is more common in sports such as weightlifting, football and gymnastics.
- degeneration of joints through arthritis. The joints become worn and lose their ability to keep the alignment of spine in its normal position. This is also known as degenerative spondylolisthesis and is more common in older adults.
- a sudden injury or trauma to the spine. Also known as traumatic spondylolisthesis, the fracture of the pedicle, lamina or facets can cause the disc to slip forward.
- a bone abnormality. Pathologic spondylolisthesis is cause by structural weakness of the bone usually causes by a bone disease or a tumor.
Symptoms of Spondylolisthesis
The most common symptom of spondylolisthesis is a lower back
pain. This usually gets worse with activity or prolong standing, and is often
relieved by lying down. The pain can also extend into the buttocks or posterior
thigh in some cases. Other symptoms include:
-
pain, numbness, or a tingling sensation
radiating from your lower back to your back legs (sciatica)
-
hamstring tightness
-
neck stiffness
-
loss of flexibility of your spine
-
stiffness or tenderness in your back
-
muscle spasms in your back or neck
-
excessive curvature of the spine (kyphosis)
Treatment
Determining the right treatment will depend on your symptoms
and how severe they are. In most cases, non-surgical treatment is recommended
first before considering surgery. If you’re feeling pain in your back, take a
short period of rest, avoiding activities such as bending, lifting, twisting,
squatting, and playing sports. You can also take anti-inflammatory medications
to reduce swelling and/or analgesic drugs to control the pain. Simple
stretching and strengthening exercises may also help increase the range of
motion in your lower back and hamstrings. Doing hot/cold pack treatments may
also help in relieving some pain and relax your muscle tightness. If your pain
still persists and you’re unsure on what to do, consult a spinal healthspecialist like a chiropractor, who are specialized in providing non-surgical
treatments through spinal manipulations and manual therapies.
