Spondylolisthesis Pain. Treat the Root Cause NOT the Symptom

Spondylolisthesis.  A word that makes people cringe!  If you or anyone you know has "spondy", then you're acutely aware of how painful the condition can be. 


According to MedlinePlus Medical Encyclopedia, Spondylolisthesis in the adult population is "a condition in which a bone (vertebra) in the lower part of the spine slips out of the proper position onto the bone below it.  In adults, the most common cause is abnormal wear on the cartilage and bones causing degenerative disease (such as arthritis)."

 

The slip of bone usually occurs in between the fourth and fifth lumbar vertebrae.


Overtime, spondylolisthesis is associated with other spinal changes.

  1. An increased lumbar lordosis (aka swayback, when the bones of the spine appear to be forward when viewed from the side; most commonly seen in lumbar lordosis where the concave part of the low back has too much curve).
  2. Kyphosis at later stages (roundback, is when the upper back and shoulders are overly rounded forward) as the upper spine falls off the lower spine. (Image Source: About.com)

 

It is not unusual for some people to be completely asymptomatic, and others can have severe pain.  When pain symptoms so present themselves, they may include:

  • Lower back pain
  • Muscle tightness (tight hamstring muscle)
  • Pain in the thighs and buttocks
  • Stiffness of the low back
  • Tenderness in the area of the slipped disc
  • Weakness in the legs

 

Nerve damage (leg weakness or changes in sensation) may result due to an increased pressure on nerve roots and can cause pain that radiates down the legs.

 


Interestingly to me, if you do a websearch on the cause of adult Spondylolisthesis, most often the blame goes to aging, arthritis, or certain sports/activities.  

 

According to About.com, "Certain sport activities, such as gymnastics, weight lifting, and football, put a great deal of stress on the bones in the lower back. They also require that the athlete constantly overstretch (hyperextend) the spine. This can lead to a stress fracture on one or both sides of the vertebra. A stress fracture can cause a spinal bone to become weak and shift out of place."

  

However at Pain Free Posture MN we disagree in part.  While each of the activities listed above can certainly cause the vertebrae to slip, you have to ask a different set of questions.  

  • Why is the spine out of place?"  
  • Why can one athlete go through the exercise just fine and never develop spondy, when another develops the condition/injury?  Is it really the activity?
  • How come some folks age easily and never develop disc degeneration, and the next one does?  Is it really age?

 

Think about it.  Unless you have a genetic abnormality, you weren't born with Kyphosis or Lordosis.  These curve deviations are the result of muscular and joint imbalances that develop when the body is out of balance.   When you look at the posture going into the activity, it's much easier to see why certain activites can exacerbate an underlying root problem.

 

We believe that it's the body, or better said, the posture you take into the activity that affects the outcome.  Instead of asking "what's wrong", we look for the deeper issue.  

 

In my opinion, the true cause of Spondylolisthesis is not the activity itself, but the cumulative result of postural imbalances taken into the movement.

 

Our bodies have 8 Laws of Physical Health that they must adhere to.  When we violate these laws, it leaves us prone to imbalances which make us susceptible to pain and prone to injury.  Your spine has a design and function it should adhere to.  When the body is out of balance at any of the four major load joint, compensations and dysfunctions set in.  This causes a shift in our pelvis and spine, moving it out of position.  

 

If you take those imbalances into your activity, problems like Spondylolisthesis can easily occur over time.


Below you'll see a video by Brian Bradley (Vice-President, Therapy Protocol, Egoscue Inc) explaining the cause of Spondylolisthesis from a posture alignment therapy point of view, what needs to be done to correct it and why postural therapy is a highly successful way to resolve the root cause of the symptom.  

 

Remember like Pete Egoscue says, "health isn't the absence of pain.  Health is the absence of limitations"!  If you are struggling with Spondylolisthesis, start asking different questions.  What is your body telling you?  What is the root cause?  Healing can happen once you identify the "why".