Spondylolisthesis is a condition in which the spine is unstable, causing lower back pain. Spondylolisthesis is characterized by the slippage of one of the vertebrae onto the vertebrae below, potentially putting pressure on the nerves and causing leg and low back pain. While both spondylolisthesis and spondylolysis cause back pain, they are not the same. Spondylolysis is characterized by a stress fracture or crack in the spinal bones, which is very common in young athletes. Eventually, spondylolysis can lead to spondylolisthesis if the stress fracture causes a slipping of the vertebrae.
Spondylolisthesis can be caused by both degenerative changes or a spondylolysis. The discs between vertebrae and the facet joints (the joints in the back of each vertebrae that link the vertebrae together) can wear down. The facet joints can actually grow back and cause an uneven and unstable vertebral segment, further increasing pressure on the vertebrae below. Most spondylolisthesis cases do not cause symptoms. However, spondylolisthesis can cause compression or pinching of the nerve roots exiting the spinal canal which can lead to leg pain.
The Different Types of Spondylolisthesis
- Congenital Spondylolisthesis: When a baby’s spine doesn’t form the way it should, putting the person at risk for vertebral slippage later in life.
- Isthmic Spondylolisthesis: When spondylolysis causes cracks and fractures in the bone, leading to weakening of the vertebral segment.
- Degenerative Spondylolisthesis: When the normal aging and degeneration process causes weakness in the spinal discs, leading to vertebral slippage.
Spondylolisthesis and spondylolysis may occur in about 5% of the adult population. Degenerative spondylolisthesis is the most common type, occurring especially after age 50 in women more than men. One of the most common reasons for back pain occurrence in teens is usually due to isthmic spondylolisthesis.
Risks To Developing Spondylolisthesis
- Athletics: Young athletes who participate in sports that stretch the lumbar spine are more likely to develop spondylolisthesis.
- Genetics: Some people are born with thinner sections of the vertebra that are more likely to fracture and slip later life.
- Age: Aging causes degenerative changes to occur and can lead to weakening of the spine.
Low-grade Versus High-grade Spondylolisthesis
- Low-grade (Grade I and Grade II): Doesn’t require surgery. Low grade is typically seen in adolescents with isthmic spondylolisthesis and in degenerative spondylolisthesis.
- High-grade (Grade III and Grade IV): May require surgery especially if there is a lot of pain.
The Most Common Signs & Symptoms of Spondylolisthesis
- Low back pain
- Hamstrings muscle spasms
- Back stiffness
- Difficulty walking or standing for long periods
- Pain when bending over or backwards
- Numbness, weakness or tingling in the foot
(Source: Cleveland Clinic)
What Are the Treatments for Spondylolisthesis?
Marcel Jacobs PT provides a hands-on physical therapy approach which means you’re going to get fast access to immediate care in order to soothe and relax those tight and aching muscles, mobilize and loosen those restricted and painful joints, and strengthen your body so that you can go back to doing the things that you love. Your therapist will perform a thorough physical examination and evaluation in order to provide you with a deeper understanding of your impairments, compensations, and dysfunctions. You may find yourself having your concerns eased, questions answered, and physical pain reduced inside of 45 minutes with your physical therapist.
