Treatment for Spondylolisthesis

spinal stenosis

Have you been diagnosed with spondylolisthesis?

Spondylolisthesis is a low back condition which often begins in adolescence. It starts with a stress fracture of one of the vertebrae of your low back.

One of my cases involved a 16-year old boy who played baseball. Every time he swung the bat and missed (which, of course, happens a lot of the time) his low back would end up in an extreme twisted position. Over the months, his bones couldn't take it, and a stress fracture resulted.

Spondylolisthesis is also relatively more common in young dancers and gymnasts who repeatedly bend backward.

Sometimes the fracture of spondylolisthesis will cause pain, but often the discomfort will go away fairly quickly without treatment. If it does, you may not even know you have spondylolisthesis.

Unfortunately, the stress fracture allows for instability of spinal alignment. Over the years, with further deterioration of the discs and other supporting ligaments, the vertebra can slide forward relative to the bone below. Then symptoms of pain, movement restriction, and nerve impingement can occur.

One of the standard ways to diagnose spondylolisthesis is with conventional low back Xrays. In addition to side and front-back views, a diagonal (oblique) X-ray view can zero in on the exact location of the vertebral arch fracture.

MRI's can also be used in diagnosis.

If your forward slippage continues to get worse, or you begin to experience nerve impingement as a result of spondylolisthesis, you may even require surgery to stabilize your low back.

But it need not be that way. Many adults with spondylolisthesis have no symptoms whatever, and their condition is only diagnosed by chance.

What's the secret to avoiding spondylolisthesis-related problems?

Proper exercise and postural awareness are key.

The problem is that the wrong exercises - or even the right exercise done the wrong way - can make your problem worse.

Abdominal support of the spine to maintain a neutral spinal alignment is all-important. The simplest exercise to strengthen your abdominal support is the plank pose. Begin by holding the pose for 30 seconds, making sure your back is straight.

If your abdominals ae out of shape and holding for 30 seconds is a challenge, begin with 10 seconds repeated three times. Ultimately you'll develop the strength to hold the pose for 30 seconds.

Once you can maintain straight alignment in the plank pose for 30-90 seconds, you can advance to a more difficult variation, such as placing your feet on a low bench so that your trunk is angle downward.

Avoid sit-ups, curl-ups or crunches - they can actually put more stress on your discs and make your condition worse.

You do want to maintain full range of motion of the spine. You can do this with variations of the cat or dog pose. But avoid prolonged or extreme forward bending, such as in bending forward to touch your toes. And too many downward-facing dogs in yoga class could backfire.

Similarly, extreme or prolonged backward bending could also create problems. Even the simple cobra pose might allow an opportunity for forward vertebral slippage. Instead, perform a backward bending pose while lying on your back. That way, gravity will tend to pull the offending bone backward, instead of allowing it to slip further forward.

If you have tight hip flexors, they might tend to drag your low back forward, making your spondylolisthesis worse. It's important to stretch your hip flexors, but you have to perform the stretch while avoiding backward-arching (extension) of your low back. That's hard to describe briefly - but I've got specific pictures of a safe way to stretch your hip flexors available in my downloadable Doctors' Guide to Spondylolisthesis.

Many people with spondylolisthesis leave a fully active life without pain or other limitation. By following a few simple precautions you can join them.