What is spondylolistheses?
Spondylolisthesis is what happens when a vertebra (a bone that makes up the spine) slips out of place; this is different to a slipped disc where one of the discs that sits between each vertebra tears.
There are 4 grades of spondylolisthesis and they vary depending on how much the vertebra has slipped:
Grade I: Grade II: up to 50% slip
Grade III: up to 75% slip
Grade IV: >75% slip
The most common area for spondylolisthesis is L5-S1 which is at the very bottom of your spine where your spine meets your sacrum (tailbone).
What causes spondylolistheses?
Spondylolisthesis can present in children due to a birth defect for example if you have thin bones that are more susceptible to injury in that part of the spine.
Spondylolisthesis is usually caused by wear and tear of the spine in adults, though it can also occur due to a sudden trauma or direct injury.
Less common causes include:
- A fracture due to a prolonged spinal pressure such as weight lifters and gymnasts or due to sudden injury
- Bone disease for example Pagets disease
What are the symptoms of spondylolistheses?
If you have spondylolisthesis you will typically feel more pain when you do things that straighten your spine or lean backwards (extend the spine), particularly if you repeat this activity a lot or if it performed for a long period of time.
Bending the spine forwards may ease the pain.
Other symptoms include: pain, tingling or numbness in your legs (sciatica due to the vertebra pinching a nerve), stiffness, and tenderness in the region, tightness in your hamstrings muscles and a curve in the spine (kyphosis).
The higher the grade of spondylolisthesis the more you will feel your symptoms.
How is spondylolistheses diagnosed?
Spondylolisthesis is often diagnosed with an X-ray investigation. Your physiotherapist can carry out a full subjective and objective assessment and if they suspect you have spondylolisthesis they may refer you to your doctor for scans to confirm diagnosis.
What treatment can Farrell Physiotherapy offer for spondylolistheses?
After your initial assessment you will be given a treatment programme based on what was found on assessment. Each treatment plan is individual and will incorporate your lifestyle and goals. There are several different physiotherapy treatment options available.
Treatment may include:
- Joint mobilisation
- Soft tissue massage
- Graded return to activity
- Advice and education
- Biomechanical correction
If your symptoms are particularly bad then sometimes surgery is necessary. Surgery involves fusing the vertebra that has slipped to the vertebra next to it using rods or metal screws.
Benefit of physiotherapy for spondylolistheses?
Physiotherapy can be very beneficial for spondylolisthesis. The benefit you receive will be different depending on what your original symptoms are and what your goals are.
Benefits of physiotherapy include:
- Reduced pain
- Increased range of movement
- Increased function
- Increased strength
- Decreased stiffness