Patient in his mid-fifty's visited the clinic because of worsening low back pain when sitting for a long time and tingling sensation in the leg at evening. The low back pain started several months ago, and the leg pain and cramping started three weeks ago. The patient assumed lumbar herniated disc disorder and visited the clinic.
Spondylolisthesis developed from a classical spondylosis of L4 and L5 was shown in the MRI. The spine is composed of small vertebrae stacked on top of the other like a tower, and a ring shaped articular process in the back of the vertebra serves the purpose of fitting with vertebrae above and below. An unfamiliar disease Spondylolisthesis is the forward displacements of the top vertebral bone over the bottom one, occurring after a fracture of the articular process has stretched the joint between vertebrae. On the contrary, herniated disc is the displacement of the disc to the rear, compressing nerves and causing radiating pain towards the leg.
The cause of Spondylolisthesis includes weakened spines from fracture of the articular process, spondylosis, degeneration of disc and joints due to aging, defective congenital development of the spine, and malignant tumor followed by excessive exercise, accident, trauma, etc. Those with spondylosis must be careful when lifting heavy weight constantly or overly exercising because fracture can develop to spondylolisthesis.
Symptoms for Spondylolisthesis includes lumbar pain when standing up from sitting or bending the back backwards. There is lumbar or sacral pain as well as pain below the knee when waking up in the morning, standing or walking for a long period of time. In severe cases, the uneven and protruded area can be felt while having the back straight and palpating the spine downwards. Any pressure over that area can induce pain. In cases for congenital defect, there is absence or weak signs of symptoms at young ages because the joints and surrounding tendons and muscles with supporting structure are strong; however, the symptoms develop when reaching forty's and fifty's.
Spondylolisthesis treatment focuses in eliminating inflammation around the soft tissues and separated spine, and in strengthening the tendon to pull the protruding bone backwards. In case of severe pain, acupuncture treatment is effective in relaxing the stiff and tense muscles. Patient must consider surgery if there are no improvements after five months of treatment. Medicinal treatment is recommended after surgery to prevent any side effects and relapse.
Patients believe the displaced bones must be returned to its appropriate location; however, the bone cannot be restored back to its place once it has become displaced. Treatments that forcefully pushes in the protruding bone can actually hasten muscle and tendon degeneration. Although one may have gotten diagnosed as Spondylosis due to defective congenital development or accident at young age, not all Spondylosis patients develop to Spondylolisthesis. Spondylolisthesis is developed generally in those approaching forty's or fifty's, and the muscles and tendons around the facet joints degenerate and lose their function. Therefore, if the surrounding muscles and tendons of the spine are functional, then it can prevent Spondylolisthesis.
Constant stretching and maintaining of right posture are important in preventing any spinal disorder. Strengthening of the spinal muscles with walking exercise is required. Wear comfortable shoes with cushion when walking, and focus on putting the weight from the heel of the foot and moving the weight towards the big toe while flexing the abdomen and straightening up the back. Getting treatment even for minor pain is a shortcut to preventing bigger diseases.