What is Spondylolisthesis?
There are two types of Spondylolisthesis. Degenerative Spondylolisthesis is a condition which occurs when a stress fracture to one of the vertebra (bone) in the spinal column, slips out of its normal position over the one below it. This is usually due to aging where the spine’s support system (bones, joints and ligaments) weakens and is no longer able to keep it aligned. With Isthmus Spondylolisthesis, the slippage of the vertebra (bone) is due to a small fracture in a piece of bone that connects two joints in the spine. This fracture to the pars interarticularis (small piece of bone) is the result of stress to the bone. In this case, it is most likely that the fracture occurred when a child is around 5-7 years old, yet the symptoms may not be felt until they have reached adulthood.
Spondylolisthesis usually affects the lower part of the spine, most commonly the 5th lumbar vertebra, but sometimes the 4th lumbar vertebra. In some cases, the bones may press on or squeeze the nerves causing back pain and possibly, some numbness on one or both of your legs.
In extreme cases, there may some loss of bladder or bowel control, in which case you must seek immediate medical help.
What are the Symptoms of Spondylolisthesis?
In some cases someone who has Spondylolisthesis may have no symptoms.
For those that do, you may experience the following;
Pain from the lower back down one or both legs
Weakness in one or both legs
Numbness in one or both legs
Problems with walking
Pain in the leg, back or buttock that becomes more painful
when you bend over or twist
In extreme cases, loss of bowel or bladder or control
Who is Prone to Spondylolisthesis?
Spondylolisthesis may be hereditary. You may be born with thin vertebral bone making them more vulnerable to this condition. In which case, significant periods of rapid growth may lead to slippage.
Children and teens involved in sports that put pressure on the lower back e.g. football, weight lifting and gymnastics. The constant over-stretching of the spine may cause a stress fracture in either side of the vertebra.
It may also be prevalent in older adults as stress fractures or damage to the disk and joints causing slippage can be caused by general wear and tear.
TRIGGER POINT SELF TREATMENT TECHNIQUE:
This technique involves locating the heart of the trigger/tender point. When this is compressed it may well trigger a specific referred pain map (preferably reproducing your symptoms). This technique involves applying direct, gentle and sustained pressure to the point:
1. Identify the tender/trigger point you wish to work on (see illustration above).
2. Place the host muscle in a comfortable position, where it is relaxed and can undergo full stretch.
3. Apply gentle, gradually increasing pressure to the tender point until you feel resistance. This should be experienced as discomfort and not as pain.
4. Apply sustained pressure until you feel the tender point yield and soften. This can take from a few seconds to several minutes.
5. Steps 3-4 can be repeated, gradually increasing the pressure on the tender/trigger point until it has fully yielded.
6. To achieve a better result, you can try to change the direction of pressure during these repetitions.
TRIGGER POINT SELF HELP - ADVICE
There are many reasons why you might have trigger points, so it is important to consider your trigger point pain in the context of the rest of your body. It must be stressed that the techniques offered on this page are not a substitute for therapy from a qualified practitioner; although aches and pains from trigger points are common, there can sometimes be an underlying pathology. It is advisable to always seek a proper diagnosis from a qualified medical practitioner or experienced manual therapist.
Stretching is an important part of the rehabilitation process and should begin as soon as pain allows and be continued throughout the rehabilitation program and beyond - Good maintenance prevents re-injury.
• Lie on your back on a mat or the carpet
• Place a small flat cushion or book under your head
• Bend your knees and keep your feet straight and hip-width apart
• Keep your upper body relaxed and your chin gently tucked in
• Bend one knee up towards your chest and grasp your knee with both hands
• Slowly increase this stretch as comfort allows
• Hold for 20-30 seconds with controlled deep breaths
• Do not tense up through the neck, chest or shoulders
• Only stretch as far as is comfortable
Grasp both knees and press into chest
Repeat three times, alternating legs, twice daily