Spondylolisthesis is a spinal condition in which one vertebra slips forward over the vertebra below. Degenerative spondylolisthesis, usually occurs in the lumbar spine, especially at L4-L5. It is the result of degenerative changes in the vertebral structure that cause the joints between the vertebrae to slip forward.
Spinal fusion between the fifth lumbar vertebra and the sacrum is the surgical procedure most often used to treat patients with spondylolisthesis. The goals of spinal fusion are to: Prevent further progression of the slip. Stabilize the spine.
Spondylosis can lead to spinal stenosis, which is a narrowing of the spinal canal. As a result, the spinal cord and/or spinal nerve roots can become compressed (pinched). For example, the cervical spinal cord can be affected by compression from spondylosis.
Fortunately, lumbar spondylosis often can be treated without surgery. Medical treatment options include pain relievers, muscle relaxants, anti-inflammatory medications, and steroid injections. Physical therapy and hot- and cold therapy are also helpful in alleviating pain.
There should be restriction of heavy lifting; excessive bending, twisting, or stooping; and avoidance of any work or recreational activities that cause stress to the lumbar spine. Your physician will outline a rehabilitation program to return you to your activities as soon as possible.
The principal symptoms that aggravate lumbar spondylosis are lifting excessive loads, particularly where the back is unprotected. Lifting large loads away from the body and also any lifting which involves a rotational movement can be especially harmful.
Other research supported that walking is as effective as conventional physiotherapy treatment such as lumbar stabilisation and muscle strengthening exercise.
Compression or inflammation of the L5 and/or S1 spinal nerve root may cause radiculopathy symptoms or sciatica, characterized by: Pain, generally felt as a sharp, shooting, and/or searing feeling in the buttock, thigh, leg, foot, and/or toes.
L5 spinal nerve provides sensation to the outer side of your lower leg, the upper part of your foot and the space between your first and second toe. This nerve also controls hip, knee, foot and toe movements. The sciatic nerve consists of the L4 and L5 nerves plus other sacral nerves.
Over-the-counter (OTC) medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) are usually tried first for pain stemming from L5-S1. For more severe pain, prescription medication, such as opioids, tramadol, and/or corticosteroids may be used.
If left untreated, spondylolysis can progress to spondylolisthesis, a condition in which a vertebra, weakened by fracture, slips out of alignment with the rest of the spine. The risk of spondylolysis is higher during growth spurts.
If you have spondylolysis, nonsurgical treatments like rest, medication and physical therapy should improve your symptoms. These treatments can't undo the fracture, but they can help you return to your daily activities without pain as soon as possible.
Over time, a degenerating disc may break down completely, leaving no space between two vertebrae, which can result in impaired movement, pain, and nerve damage. The pressure can cause pain, weakness, and numbness in the back and the legs.
Sitting doesn't directly cause spondylolisthesis. However, in patients who have spondylolisthesis, sitting can trigger pain flare-ups. Specifically, sitting in a slouched, twisted, or bent position can lead to spondylolisthesis pain.
Bed Rest: Severe instances of spondylitis may require bed rest for close to 1-3 days. Long-term bed rest is avoided as it puts the patient at danger for profound vein thrombosis (DVT, blood clots in the legs).
Causes of AS Flares
In a study on AS flares, patients reported “the main perceived triggers of flare were stress and 'overdoing it,'” Dr. Appleyard says. “Keep in mind 'stress' may mean both physical stress, such as an illness, or emotional stress. Excess fatigue may also trigger a flare.”
Technically, spondylosis is a form of arthritis—spinal osteoarthritis (osteoarthritis is the most common type of arthritis) to be exact. We tend to think of arthritis as something you get in your hands and knees, but the spine, and all of its bones and joints, can fall victim to its grip as well.
When there are symptoms, back pain and stiffness are the main ones. They are usually worse in the morning and get better throughout the day. If bony growths are pushing against a nerve root or the spinal cord, you may have numbness, tingling, weakness, or an aching, shooting pain in your buttock and leg.
Because spondylosis of the lumbar spine is a degenerative condition, there is no permanent cure for it, however there are various treatment options that can slow the process, reduce the symptoms, and improve the patient's quality of life.