Back pain can be due to many causes. Among some of these are muscle or ligament strain, injury, a slipped disc, an improper mattress, and osteoporosis to name a few. One of the lesser-known reasons for back pain is something called spondylolisthesis. This condition occurs when one of the bones of the spine (otherwise known as a vertebra) slips out of place and onto the vertebra below. This usually happens in the lower (lumbar) region of the spine, although it can occur in other areas of the spine as well. Often times there are no symptoms, however, if the slipped bone compresses a nearby nerve, the result can be pain in the back and other areas of the body.
What Causes Spondylolisthesis?
There are a variety of causes of spondylolisthesis since vertebrae can become damaged or displaced for a number of reasons. Some of these include:
● Birth defect – sometimes there can be a malformation of vertebrae present from birth
● Aging – often leads to degenerative disc disease which is the break-down of the cushion-like discs between the vertebrae
● Spondylolysis – a condition which causes small stress fractures in the vertebrae
● Trauma – spinal injuries and surgery can cause vertebral fractures and slippage
● Disease – such as osteoporosis, can weaken the bones, causing displacement
What Are the Symptoms of Spondylolisthesis?
Even though spondylolisthesis often occurs without symptoms, if the case is more severe or worsens, the most common symptoms to appear are:
● Pain in the lower back (that may extend into the legs)
● Tingling or numbness in the legs or feet due to nerve compression
● Muscle tension and stiffness in the back
● Spasms in the hamstrings
How Is Spondylolisthesis Diagnosed?
After reviewing your medical history and performing a physical exam, your doctor will order an imaging test to determine whether or not you have spondylolisthesis. This is usually in the form of an X-ray, but sometimes a CT scan or MRI may be required.
After review of the imaging test, the degree of slippage (or severity of spondylolisthesis) can be determined. Slippage is graded on a scale I through IV:
● Grade I: 1% to 25% slippage
● Grade II: 26% to 50% slippage
● Grade III: 51% to 75% slippage
● Grade IV: 76% to 100% slippage
What Is the Treatment for Spondylolisthesis?
Treatment for spondylolisthesis depends on multiple factors such as your age, overall health, degree of vertebra slippage, and the severity of your symptoms. All of these will determine which of the following treatment or treatments are best for you:
● Rest – ceasing physical activity and restriction of any movements that might cause stress to the spine for several days
● Physical therapy – this includes specific exercises to stabilize the back and spine and may include wearing a corset or brace for some time
● Pain medications – depending on your pain level this could include over-the-counter and prescription drugs
● Epidural steroid injections – to reduce pain and inflammation, medication can be injected directly into the space around the spine during an out-patient procedure
● Surgery – in some severe cases, surgery might be required which may include a procedure called spinal fusion