Spondylolisthesis occurs when a vertebra in your spine slips out of position, causing it to rest in an abnormal position on the vertebra below it. Most often, this occurs in the lower spine, between the fourth and fifth lumbar vertebrae in adults, although spondylolisthesis can occur among two (or more) vertebrae anywhere along your spinal column.
Your Symptoms Depend on the Degree of Slippage
There are varying grades of severity (from 1 to 5) with spondylolisthesis; grade 1 is the least severe, with less than 25 percent slippage, while grade 5 indicates the top vertebrae has fallen completely off the supporting bone below it (otherwise known as 100 percent slippage).
Depending on the grade, you may feel no symptoms at all, or you may have severe lower back pain, pain in your legs, thighs and buttocks, and even numbness, tingling, radiating pain or weakness in your legs, which are signs of nerve damage resulting from the pressure of your vertebra on your nerves. In the most severe cases, severe vertebra slippage from spondylolisthesis can cause an inability to control urine or stool, or initiate urination.
This indicates that the vertebra may be pushing on your spinal cord and is a medical emergency that requires immediate medical attention.
What Causes Spondylolisthesis?
In children spondylolisthesis may be due to a birth defect or an injury to the spine. In adults, the condition is often related to degenerative disease such as arthritis, although other causes, such as bone diseases, fractures, or injuries from gymnastics, weight lifting football or other activities, also exist. In fact, the most common cause of low back pain among adolescent athletes is a stress fracture in one of the vertebraes, known as spondylolysis.[i] If the fracture becomes severe enough that the vertebrae cannot maintain its position and shifts out of place, spondylolisthesis occurs.
As you age, the discs in your spine, which act as cushions for your vertebraes, lose water and become less spongy, which can also contribute to degenerative spondylolisthesis.
In many cases, weak core muscles in your back, abdomen and pelvis are another contributing (and easily modifiable) risk factor, as these muscles (29 in all) not only help control your movements and provide greater balance and stability, but also protect and support your back. Weak core muscles increase your risk of lower back pain and injury, and may lead to pelvic dysfunctions that put abnormal pressure on your spine and prevent it from stabilizing properly, leading to pain.
Spondylolisthesis Treatment Options
Spondylolisthesis is generally diagnosed using an X-ray, CT scan or MRI of your back in order to reveal the out-of-place vertebrae. Treatment then depends on the degree of severity. Generally, conservative treatment will be offered if your degree of slippage is 50 percent or less. Most commonly, this involves:[ii]
- Avoiding sports or other physical activities to rest your spine and allow pain to subside
- Over-the-counter or prescription anti-inflammatory drugs, as well as steroid injections, to help relieve pain and inflammation
- A back support brace to help stabilize your lower back
- Physical therapy and specific stabilization exercises to improve flexibility and muscle strength
In more severe cases, or if the steps above do not eliminate pain and other symptoms, a surgical procedure may be suggested. This may involve either removing part of the bone that is pressing on your nerves (laminectomy) or a spinal fusion, in which a piece of bone is transplanted to your spine, creating a solid mass that helps stabilize the spine.
Once slippage in your spine has occured — or you have been diagnosed with a progressive form of spondylolisthesis — it is recommended that you seek professional help from a qualified expert in spondylolisthesis who can initiate the most comprehensive and conservative treatment approach possible.
Spinal Surgery Should be Your LAST Resort
There are cases where surgery for spondylolisthesis is appropriate, but this is the rare exception and only for severe cases. You might be surprised to learn, in fact, that your surgeon’s level of enthusiasm about spinal surgery is the most dominant factor influencing surgical rates![iii] This means that if your surgeon believes back surgery — which can cost upwards of $80,000 — is the go-to option to relieve back pain, you’re much more likely to schedule this procedure, compared to those whose surgeon advises other less-invasive options first.
Before you opt for surgery, it’s important that you also understand fusion surgery rates have increased dramatically in recent decades,[iv] even though the procedure is often unsuccessful and even debilitating. Writing in the journal Spine, researchers noted:[v]
“Patients should be informed that the likelihood of reoperation following a lumbar spine operation is substantial.”
Further, spinal fusion surgery is associated with a significant increase in disability, opiate painkiller use, and prolonged inability to work.[vi]
So if you have a mild or moderate form, take advantage of the far less invasive options available to you — options like Heal-n-Soothe, a natural anti-inflammatory that contains 12 of the most powerful and safest anti-pain ingredients, which can decrease your pain without any of the serious side effects often posed by anti-inflammatory drugs or surgery.
There are many other strategies as well. Massage, exercise, hot packs on your spine, and more can help you to beat back pain naturally, in far less time than you might think. To learn about all the natural options available to you, sign up for the free LosetheBackPain.com newsletter, and experience what it’s like to live free of back pain in just days — without drugs or surgery!
According to the Cleveland Clinic, conservative treatment for mild cases of spondylolisthesis is successful in about 80 percent of cases[vii] — so resist subjecting yourself to invasive surgery until you know if yours is one of them!
As an aside, you can help to reduce your risk of this condition in the first place by following a few sensible lifestyle strategies, including:
- Strengthening your core muscles with core exercises
- Maintaining a healthy weight
- Eating a balanced, predominantly whole-food diet to provide vital nutrients for your bone and over health
Want to learn more — and find back pain relief without unnecessary surgery or drugs? The Web’s best back pain newsletter can deliver tips to Inbox weekly, starting right now (subscribe FREE toward the top of the page to the right)!
Written By: Updated: February 15,2012