Spondylolisthesis

Spondylolisthesis in the lumbar spine occurs when one of the spinal lumbar vertebra slips forward on the one below. It can also occur in the neck (cervical vertebra), but is much more common in the lower back.

In some cases spondylolisthesis can lead to compression of the spinal cord and/or the spinal nerves. This may cause back leg pain as well as possible numbness or tingling in the legs. Often the symptoms are hard to distinguish from spinal disc problems. Bad cases of spondylolisthesis can affect bowel and bladder function, and you should see a health professional if this is the case. Luckily most cases of spondylolisthesis in the lumbar spine can be relieved by doing some simple exercises.

What Is Spondylolisthesis?

Spondylolisthesis is known to be a fairly common cause of lower back and leg pain in younger adults and teens as the result of a spinal fracture, and in older adults as a result of degenerative change in the spine. It is usually graded from 1 to 5 depending on the amount of forward slippage.

Spondylolisthesis can be classified in to 5 different types or causes.

1.Isthmic. This is the most common form of spondylolisthesis and is estimated to affect 5-7% of the population, although it mostly does not cause any symptoms. It occurs when there is a small fracture in the pars interarticularis, a part of the bone at the back of the spinal vertebra.

This fracture is not usually a result of a trauma, but rather it is caused by an accumulation of stress on the bone and rarely will cause pain when it happens. Isthmic spondylolisthesis usually occurs at quite a young age (between 5 and 16 years of age), but may go unnoticed until you are an adult.

It is more common in sports, particularly gymnastics and weight lifting.

2. Degenerative. Degenerative change of the spinal facet joints can lead to instability and weakening of the Ligamentum Flavum, allowing the affected vertebra to slide forward on the one below.

3. Traumatic. Occurs very rarely when there is an acute fracture to the spinal vertebra, other than at the pars interarticularis.

4. Pathological. As a result of damage to the vertebra due to bone disease such as tumours, metastases, or Paget’s disease.

5. Dysplastic. A rare congenital condition due to malformation of the spine.

Symptoms of Spondylolisthesis.

The most common symptom of spondylolisthesis is lower back pain. This is often worse after exercise, especially activities that involve extension (leaning backwards) of the lumbar spine.

Leg pain is also common, especially pain that runs from the lower back to the buttocks and down the backs of the legs.

Other symptoms may include tightness of the hamstrings and decreased range of motion of the lower back. It may even cause difficulty walking.

Some patients can develop numbness, tingling or weakness in the legs due to nerve compression.

Severe compression of the nerves can cause loss of control of bowel or bladder function, or cauda equina syndrome. This is considered a medical emergency, and you should seek medical attention.

Spondylolisthesis Exercises

Try these simple exercises that are well known to help relieve back pain caused by spondylolisthesis.

1. Curl up into a ball. Spondylolisthesis is aggravated by spinal extension, so by pulling your knees to your chest, you are bringing your spine into a more flexed position. Start by lying on your back, them simply pull both of your knees to your chest and hold them there for 10-30 seconds.

2. Cat Stretch. Similar to curling up into a ball, cat stretches bring your spine into flexion. Start in a kneeling position, then sit back onto you feet. Stretch your arms out in front of you along the floor. Feel the stretch in your low back and hold for 10 seconds.

3. Planks. Building abdominal strength helps to give some stability to your spine, and prevents over-extension.  Basically, you need to hold still in a push-up position. Start kneeling on the floor on your hands and knees. Keep both shoulder width apart. If you have not done these before, slowly walk your hands out until your body is in a straight line, hands below the shoulders. You can hold it here, or come down to rest on your elbows, keeping them directly below the shoulders. Keep your body straight and rigid, like a plank or a bridge (see where the name comes from!).

4. Sit-ups.  Sit-ups are great for really getting your abs strong. Lying on the floor as above, lift your upper body (head and shoulders) off the floor by curling up. Don’t try to lift to high, just enough to get your shoulders slightly off the floor. Repeat 10 times. You can do more sets of 10 as you get better!

These simple exercises can make a real difference if you are suffering with spondylolisthesis in the lumbar spine. Give them a go and see if they help you out, but remember to just start slowly and gently! If this does not help you then we recommend seeking professional advice.