Pain is a signal that something is wrong – it’s part of our ‘protect and defend mechanism’.
Spondylolisthesis comes in many forms, but in almost all cases, it is an extremely painful and discomforting condition for both old and young patients. Thankfully, this is a condition that can be managed really well with some relatively simple trigger point therapy techniques.
Patients often present with slight forward (flexion) bending (the Phalen‐Dickson sign). This posture leads to buttock pain as the gluteus maximus and medius and hamstring muscles become similarly engaged in protecting and stabilizing the lower back and hips through their myofascial attachments.
Over time this leads to a ‘chronic tight clenched buttocks’ often with spasms and pain. This buttock clenching tension can be seen clearly during examination. Gluteal muscle spasm and tension can in turn lead to tension in the Piriformis muscles, which engorge and then press upon the sciatic nerve (causing sciatica) or its blood supply (pseudosciatica).
Numbness may be one sided (unilateral) or bilateral. It is usually felt down the back of the legs but this depends on where the spondylolisthesis is located. Each nerve that exits the spine has a specific radiating pattern or dermatome. See the illustration below. Often the leg pain is not directly related to pressure on the nerves, but may be coming from muscular trigger points and associated tight muscles. Tight muscles can press on the delicate blood supply to the nerves and mimic nerve pain (myogenic neuropathy). In these cases, trigger point therapy (see the NAT protocol) can be very, very effective.
The video blog above briefly covers the main NAT trigger point therapy protocols. For more detailed information, please see the NAT Home Study Trigger Point Course - Treating Spondylolisthesis.
This blog and video is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell. Do not attempt to replicate these techniques unless they fall within your professional scope of practice.
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