The word Spondylolisthesis arises from the Greek word spondylo means spine, and listhesis means slipping down a slippery path. Spondylolisthesis is a condition of the spine in which there would be a forward or backward slippage of one vertebra on an adjacent vertebra (vertebrae are small bones forming the backbone). It usually occurs in your spine in the lumbar area (lower back region).
Spondylolisthesis is categorized into 5 major types.
- Isthmic Spondylolisthesis
- Degenerative Spondylolisthesis
- Congenital Spondylolisthesis
- Traumatic Spondylolisthesis
- Pathologic Spondylolisthesis
Isthmic Spondylolisthesis is caused by a defect in a part of the vertebra called the pars interarticularis. This defect leads to the vertebrae to slip forward.
Degenerative Spondylolisthesis may be caused by arthritis occurs when the joints lose their ability to keep the alignment of the spine in its normal position. It can cause the vertebrae to slip forward.
Congenital Spondylolisthesis is caused as a result of abnormal formation of spinal bones at the time of development of the baby in pregnancy. Congenital refers to the presence of the health issue since birth. Due to malformation and miss alignment of the spinal discs, they tend to slip and result in Spondylolisthesis.
Traumatic Spondylolisthesis is caused by any trauma or injury that results in the slippage of spinal disks. The word traumatic refers to an injury that causes damage to spinal discs.
Pathologic Spondylolisthesis is caused as a result of any disease that can affect the healthiness of the spinal bones and weaken them and cause the Spondylolisthesis. Osteoporosis or any infection can cause this kind of issue.
Causes Of Spondylolisthesis
In children, spondylolisthesis usually occurs between the 5th bone in the lumbar vertebra and the 1st bone in the sacrum (pelvis) region. It is often due to acute trauma or a congenital disability in spinal discs.
In adults, it occurs commonly due to degenerative arthritis (abnormal wear on the cartilage and bones) of the spine.
Spondylolisthesis is also caused by bone disease and fractures. Certain sports activities, such as weightlifting, gymnastics, and football, put excess stress on the bones in the lower back. They also require that the athlete constantly overstretches the spinal column. It can lead to a stress fracture of the spinal vertebra. Stress fractures can cause a spinal bone to become weak and shift out of place.
Read More: Spondylosis Vs Spondylolisthesis
Symptoms Of Spondylolisthesis
The symptoms of spondylolisthesis may vary from person to person but at an acute stage may not have any symptoms. Those suffering from chronic conditions may find difficulty in performing daily activities. Some of the most common symptoms are:
- Persistent lower back pain
- Stiffness in your lower back and legs
- Muscle tightness or weakness in the lower limbs (sciatica)
- Lower back tenderness
- Thigh pain
- Tight hamstring and buttock muscle
These symptoms are usually aggravated by some of the activities such as standing, walking, while rest will provide temporary relief.
Read More: What Causes Pars Interarticularis?
Treatment Options For Spondylolisthesis
Treatment options for spondylolisthesis depend on several factors, including the age and overall health of the patient, the severity of the symptoms, and the extent of vertebral slippage. Treatment most often is conservative, involving rest, medication, and physiotherapy. More severe spondylolisthesis may require a Decompressive laminectomy or spinal fusion surgery.
The person should take a break from sports and other activities until the pain subsides. An over-the-counter NSAID (non-steroidal anti-inflammatory drugs) are recommended to help reduce pain and inflammation.
A lumbar brace or back support might be used to help stabilize the lower back and reduce pain. A program of exercise and physiotherapy will help increase pain-free movement, and improve flexibility and muscle strength.
Stabilization exercises are the mainstay of treatment. These exercises strengthen the abdominal and back muscles, minimizing the movement of the spine. Aggressive daily treatment with stabilization exercises for 8 to 12 weeks is recomended to achieve clinical improvement.
Read More: Everything About ALIF Surgery
Spondylolisthesis Exercises For Pain Relief And Back Strengthening:
After a thorough evaluation, your physiotherapist will be able to provide you with a personalized spondylolisthesis exercises program to help decrease the pain that is caused by the spinal condition called spondylolisthesis.
This program often includes lumbar flexion exercises or lumbar spondylolisthesis physiotherapy exercises, core stabilization exercises, and exercises or stretches for the muscles of the back, hamstrings, and hips. Low-impact exercises are recommended to promote healing and decrease pain, which may include swimming and cycling.
Usually, the doctors prescribe the spine strengthening exercises to strengthen the abdomen and back muscles, and also to increase the joint flexibility, which helps prevent and rehabilitate the severe type of lower back pain. Maintaining the daily activities with a tolerable limit can also help achieve a faster recovery in spondylolisthesis, instead of taking bed rest.
Common Wrong Assumptions About Low Back Pain
There are many sources of uncertainty about back pain. It seems that there is always something on the news about a breakthrough that is revolutionizing the treatment of back pain or a new book that claims to have all the answers.
Unfortunately, as many of you know, solutions for healing the back pain are usually not so simple. While some people find fast pain relief, most people find that it is a long and winding road to get a precise diagnosis and effective treatment plan. The one roadblock that may hinder a correct diagnosis is falling prey to some common misconceptions about what causes back pain or how to get better.
Below are some of the most common misconceptions associated with back pain.
Back pain can lead to paralysis if left untreated
Truth: The spinal cord comes off the base of the brain, runs throughout the neck (cervical spine) and upper back (thoracic spine)and ends at lower thoracic level. Therefore, while most problems in this area are benign, spinal cord damage may accompany injury or certain disorders of the cervical or thoracic spine (for example; an unstable fracture, spinal tumor, or infection). The spinal cord (tubular bundle of nervous tissue) does not run through the lower back (lumbar spine). Because the lumbar spine (L1-L5) has no spinal cord and provides a significant amount of space for the nerve roots, even in chronic conditions (such as a herniated disc) they are unlikely to cause paralysis.
I must be more careful to protect my back to avoid further pain
Truth: Many people with low backache overprotect their backs and, as a result, are more susceptible to injury and pain due to lack of stability. To stay healthy, your spine needs regular stretching, strengthening, and aerobic conditioning exercises. An inactive lifestyle and lack of exercise can lead to lack of strength and rigidity in the spine. Unless your doctor tells you otherwise, protecting the back should primarily include the correct posture and body mechanics and physiotherapy instruction appropriate to ensure that you are exercising correctly.
Moving will make my back pain worse
Truth: The answer is no. If your back hurts–the cure may be as simple as putting one foot in front of the other. Walking can lessen pain, hasten the healing, increase flexibility, and boost strength. Walking strengthens your joints and muscles, including those in your hips, legs, feet, and torso along with the spine muscles that hold you upright. Walking benefits your circulation, helping pump nutrients to tissue and drain toxins, which nourishes your spine and prevent recurrences.
Need evidence? A study The Spine Journal in 2004 showed that a single session of an exercise such as walking could reduce low back pain from 10% to 50%. Moreover, a 1993 study found that just TEN minutes of treadmill walking led to a significant reduction in back pain.
An MRI scan or another diagnostic test is needed to diagnose my back problem
Truth: Most health professionals can develop a successful treatment approach based on the physical examination along with a complete medical history. Only specific patterns of symptoms in a minority of cases indicate the need for an MRI or other diagnostic tests. Typically, an MRI is used when patients do not respond to appropriate low back pain treatment.
I will need surgery because I have a severe back pain
Truth: Many people with back pain wonder if they will need back surgery and if and when they should consult a spine specialist. For most instances of back pain, it is advisable to start off with a physical exam by the primary care physician or from a physiotherapist before seeing a spine surgeon.
Top 10 Strengthening Exercises For Spondylolisthesis
These are the top 10 spine strengthening exercises or spondylolisthesis exercises
Your doctor or physiotherapist may suggest you do some of the below-mentioned spine strengthening exercises to relieve the back pain caused by spondylolisthesis.
Note: It is advised to take proper medical advice before practicing any exercises mentioned below.
1. Spondylolisthesis Exercises – Pelvic Tilt Exercise
- Lie on your back with the knees bent, feet flat on the floor.
- Pull your belly button inwards imagining that you are pulling towards your spine and push lower back towards the floor.
- Flattening your back.
- Hold for 15 seconds, and then relax.
- Repeat five to ten times.
Read More: Top 10 Exercises For Cervical Spondylosis
2. Spondylolisthesis Exercises – Gluteal Stretch
- Lie on your back with your knees bent.
- Bring one knee up and pull it gently into your chest for 10-15 seconds, and then relax.
- Repeat five to ten times for each side.
3. Spondylolisthesis Exercises – Bridging Exercise
- Lie on your back with both knees about 900.
- Push your feet into the floor.
- Squeeze or tighten your buttocks, and lift your hips off the floor until the shoulders, hips, and knees are all in a straight line.
- Hold for about 5 sec, and then slowly lower your hips back down to the floor and rest for up to 10 seconds.
- Repeat 10 times.
Using backrest for your chair may help to minimize the risks involved due to poor posture, for those who have to spend more time sitting.
4. Spondylolisthesis Exercises – Back Exercises For Spondylolisthesis
- Lie on your back, hands above your head.
- By placing your feet flat on the floor bend the knees and roll them to one side. Do it slowly.
- Hold for 10 sec.
- Repeat 3 times on each side.
5. Spondylolisthesis Exercises – Deep Lunge Exercise
- Kneel on your knee, the other foot in front.
- Facing forwards, lift the back knee up.
- Hold for 5 seconds.
- Repeat 3 times on each side.
6. Spondylolisthesis Exercises – Curl-ups (Partial) Exercise
- Lie on your back, bend your knees by placing your feet flat on the floor.
- Do not press your lower back or neck against the floor.
- Curl halfway up by tightening your abdomen, keeping the head in line with the shoulders.
- Hold this for 5 sec.
- Uncurl to lie down.
- Repeat 3 sets of 10.
7. Spondylolisthesis Exercises – Knees To Chest Exercise
- Lie down facing up bring both knees toward your chest then pull your knees as much as you can.
- Hold for 10-20 sec return your legs to the floor.
- Do the exercise about 10 times.
- You can do this exercise with single or both legs once.
Read More: Knee Pain Relief Exercises
8. Spondylolisthesis Exercises – Side Plank Exercise
- Lie on your right/left side with your legs straight.
- Support your upper body with your right forearm and push-ups sidewise so that your body forms a diagonal line.
- Rest your left hand on your hip.
- Brace your abs and hold for 1 min or 30 seconds.
- Make sure to keep your knees and hips off the floor.
9. Spondylolisthesis Exercises – Quadruped Arm/Leg Raise Exercise
- Get down on your hands and knees.
- Tighten your abdominals to stiffen your spine.
- By keeping your abdominal muscles tight, raise one arm and the opposite leg away from you.
- Hold this position for 5 seconds.
- Slowly bring down your leg and arm.
- Repeat the same on the alternates side.
- Do this 10 times on each side.
10. Spondylolisthesis Exercises – Dead Bug Exercise
- Lie on your back.
- Tighten abdominal muscles and raise your legs off the floor at a 900 angle so your legs are parallel to the floor.
- Lift your arms, then push them into your thighs.
- Lower your left leg and right arm simultaneously until they are just off the floor.
- Pause for a second in this position and return to the starting pose.
- Repeat the same with the leg and arm on the other side.
- Perform 10 repetitions.
Read More: Exercises for Iliotibial Band Syndrome
What Are The Exercises To Avoid With Spondylolisthesis?
Avoid exercises that put pressure on your spine like weight lifting, exercises that put pressure and twist your lower back or lumbar spine. Activities and sports like gymnastics, football, competitive swimming, and diving are not advised to perform if you are suffering from Lumbar Spondylolisthesis.
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Dr. Kaleem Mohammed graduated as a Bachelor of Physiotherapy in 2014 from Deccan College of Physiotherapy, affiliated to Dr. N.T.R. University of Health Sciences, Vijayawada, India. Dr. Kaleem is an expert at handling physiotherapy needs of patients suffering from orthopedic and spinal conditions and post-surgery rehabilitation. Dr. Kaleem is associated with HealthClues since its inception where he facilitates diagnosis and advanced consultation with senior doctors. He is also a medical researcher and prolific writer who loves sharing insightful commentaries and useful tips to educate the patient community about fitness, treatment options, and post-treatment recovery.