Spondylolisthesis is a spinal condition in which one vertebra is displaced horizontally relative to the underlying vertebra. The most common case is listhesis of the lumbar spine; listhesis of the cervical spine is less common and almost never of the thoracic spine. Complex cases require surgery. Important! Any manual therapy techniques are contraindicated and dangerous to health.
There are a huge number of reasons for such displacements, but the most important thing with listhesis is maintaining the stability of the spinal segments. A specially designed exercise program is aimed at strengthening the deep muscles of the back and abdomen. Do not start exercising without first consulting your doctor!
To rehabilitate the cervical spine, you need to use Exercises to strengthen the neck muscles.
To increase blood circulation and eliminate muscle blocks, it is recommended to undergo 3-5 sessions of massage and muscle stretching from a qualified specialist.
Clothes should be loose, it is advisable to remove shoes. Perform all exercises (especially the first days) smoothly and gradually. Remember the important principle: “Endure mild pain, do not allow severe pain.”
Do these exercises daily for at least 2 weeks.
Beetle movement
Lying on your back, legs bent at the knees, arms along the body.
Tighten your abdominal muscles. While maintaining tension, lift one bent leg a few centimeters from the floor and hold it for 5 seconds, then lower it. Repeat the exercise with the second leg. Then raise your arm above your head and hold it for 5 seconds. Then lower and repeat the exercise with the other hand. Repeat 5 times with each arm and leg. As soon as the exercise ceases to be difficult for you, begin to lift your leg and the opposite arm at the same time. Hold also for 5 seconds. 3 sets of 5 reps on each side.
Treatment methods ↑
At the very initial stages of the disease, conservative treatment methods are used.
These include:
- relieving pain and inflammation using medications;
- the use of orthopedic products that fix the spine;
- physiotherapy.
If all of the above methods cannot cope with the problem that has arisen or the disease has reached its final stage, then surgical intervention is resorted to.
But still, the most effective and affordable method of treating spondylolisthesis is physical therapy, which will be the rest of the story in the article.
Twist
Lying on your back, legs bent at the knees, arms along the body. Tightening your abdominal muscles, lift your shoulder blades off the floor and stretch your arms towards your legs. Hold the achieved position for 3 seconds. Do not hold your breath. 2 sets of 15 times. If you clasp your hands behind your head and spread your elbows to the sides, the effectiveness of the exercise increases significantly.
Symptoms of the disease ↑
Spondylolisthesis manifests itself in different ways, depending on the degree of its development:
- first degree displacement (up to 25% of the width of the entire vertebral body) occurs very often and is not accompanied by any extraneous symptoms;
- the second degree of displacement (50%) is more pronounced and causes pain in the lumbar region, which is accompanied by radicular symptoms - shooting pain radiating to the lower extremities and intensifying with any load on the spine;
- third degree of displacement (more than 50%). It is characterized by the formation of pain with almost any minor concussion of the spine (unsuccessful descent or ascent of stairs, etc.). A spasm of the paravertebral muscle appears, as a result of which the patient’s active and passive movements are sharply reduced. The displacement of the vertebra can be felt with your hands.
Some experts also distinguish stages 4 and 5, when a vertebra “falls out” into the pelvic area.
Possible consequences and complications
Spondylolisthesis is a dangerous pathology characterized by almost unpredictable consequences. Against the background of displacement of the vertebrae, problems such as pinched nerve roots and narrowing of the spinal canal may appear. Developing diseases and their specificity are directly related to the location of the affected area:
- Cervical region. Failures in this area directly affect the functioning of organs located in the head. There are problems with the functioning of receptors, dysfunction of the organs of vision, hearing or smell. Some experience neuritis and malfunction of the thyroid gland. Compression of the spinal cord in this part can even lead to death.
- Thoracic department. The disease can provoke a variety of changes in the body, occurring in the middle part of the spine. These can be pathologies of the liver, pancreas, intestines, esophagus, heart, and circulatory system. Dysfunction in some people is even observed in the functioning of the lymphatic system and adrenal glands.
- Lumbar and sacrum. The lower back is responsible for the functioning of the genitourinary system, so spondylolisthesis causes pathology of the colon, swelling of the legs, pain in the lower back, cramps, impotence or miscarriages, and menstrual irregularities.
To prevent the development of complications and disability, you should not ignore the first appearance of discomfort and consult a doctor for an accurate diagnosis. Timely prescribed therapy allows you to slow down the process, restore normal quality of life, and eliminate the risk of developing undesirable consequences.
Spondylolisthesis is a pathology in which one or more vertebrae are displaced in relation to others. This leads to the appearance of an unpleasant pain syndrome and a number of neurological disorders. It is diagnosed in people of different ages, since the onset of the disease can be triggered by a variety of negative factors affecting the spine. It is extremely important to start treatment on time to relieve unpleasant symptoms and restore normal quality of life.
Why is exercise therapy necessary for successful treatment? ↑
Physical therapy cannot completely cure this pathology - it will simply help keep it under control.
The main focus of exercise therapy is strengthening the abdominal and back muscles.
Thereby:
- lumbar lordosis decreases;
- the patient's ability to hold the torso in an upright position for a longer time appears.
According to statistics, the majority of spinal spondylolisthesis is caused by weakening of muscle groups.
When you regularly perform a certain set of exercises, the spinal column is firmly fixed in a tight muscle corset.
A set of exercises for physical therapy, as a rule, is compiled by a methodologist.
In doing so, he must take into account:
- the cause of the development of the pathology;
- patient's age;
- degree of pathological changes.
Indeed, in each individual case, methodological recommendations may differ significantly.
For example, young people involved in sports and children most often suffer from isthmic or dysplastic spondylolisthesis, but older people, those over 60 years old, develop degenerative spondylolisthesis.
Read also…. What are Schmorl's hernias in the vertebral bodies?
Wearing a corset
To prevent damage to the lumbar region after surgery, special corsets are worn. They are also prescribed to patients who are getting rid of the problem using a conservative treatment method.
Types of orthopedic structures based on rigidity:
1. Hard. The ribs of the structure are made of plastic or metal. The purpose of rigid corsets is to use them after surgery in the spinal column and for the need to undergo rehabilitation after a serious injury. The design is necessary to fix the body in a position in which displacement of damaged vertebrae is impossible. When used, the rehabilitation period is significantly reduced.
2. Semi-rigid. In this case, we are talking about protecting a sore back for people whose work activity involves either sedentary work or physical activity. This risk group includes athletes, loaders, office workers, programmers and drivers. An additional advantage of a semi-rigid corset is the ability to warm and relax the back muscles.
3. Elastic. It can be called a lightweight version of semi-rigid corsets. The functions of such a bandage are to reduce pain in the back and relax its muscles.
Types of orthopedic structures by location on the body:
1. Lumbar. This is the shortest model of all corsets because it covers and protects only the top of the pelvis, the bottom of the chest and the lower back.
2. Thoracolumbar. You can purchase a semi-rigid or rigid version of this design. It is most suitable for people after spinal surgery due to the shift of its components.
3. Lumbosacral. This model implies the presence of a back wall and is suitable for people from the already mentioned professional risk group.
Tips for choosing a corset after the doctor has determined its model:
1. Selection of material. The fiber of the belt should not cause skin rashes. You should check in advance if you are allergic to a particular material, because in some cases you will have to wear the corset for quite a long time.
2. Product quality assessment. The product must have high-quality ribs and fasteners without any defects.
3. Fit to size. The presence of a dynamic fixation in a corset is not a reason to buy an orthopedic product that will press or will not ultimately support your back in the desired fixed position.
When choosing a size, you should remember that for different manufacturing companies such an indicator as M means different parameters. In this case, a measuring tape will come to the rescue, which you should stock up on before visiting a specialized store.
The corset is worn no more than ¼ of the day, and taken off at night. The general term for its use is prescribed by the doctor.
How to determine the cause of lower back pain?
Step 1. The first thing you should try to remember is whether there has been a spinal injury in recent days? This is often why pain appears in this area of the back.
Remember if there were any spinal injuries?
Step 2. It is important to assess the level of physical activity - perhaps the spine and back simply do not have enough movement?
The use of exercise therapy for spondylosis
For many patients suffering from spondylosis, exercise therapy is the only way to maintain health . The effect of physical therapy appears after some time.
It manifests itself in:
- reducing the number of exacerbations;
- eliminating pain syndrome;
- no discomfort in the legs;
- strengthening the skeletal muscles of the back.
Spondylosis appears due to degenerative changes in the intervertebral discs . Exercise therapy restores blood microcirculation and provides adequate nutrition to the bone tissues of the spine. In addition, regular exercise helps prevent the deposition of calcium salts.
Spondylosis occurs due to degenerative changes in the spine
To get rid of spondylosis and pain, you will have to work hard. Although the exercises are quite simple, they can be difficult for a sick person to perform.
At what stage can it be used?
Exercise therapy is prescribed at different stages of spondylosis development , because it strengthens the muscles and increases the mobility of the spine. If the disease is detected at an early stage, performing special exercises becomes the main type of therapy. Sometimes the pathology can be overcome without drug treatment, but only if the osteophytes remain within the vertebrae.
It should be remembered that exercise therapy can only be used during remission . During periods of exacerbation, you should not engage in therapeutic exercises: this is fraught with increased compression of nerve endings.
Contraindications for spondylosis
When prescribing exercise therapy to a patient, the specialist must take into account certain indicators (limiting, limiting, restraining) and risk factors. This allows you to choose the right exercises and dose the load when performing them.
Limiting factors include:
- deviations in the patient’s physical development and mental state;
- associated ailments and their complications;
A risk factor is a patient's condition that increases the likelihood of injury during exercise. This condition could be :
- fragile bone callus;
- aneurysm of the heart or aorta;
- osteoporosis and other pathologies.
As for the general contraindications to exercise therapy for spondylosis, these include::
- high body temperature;
- embolism and thrombosis;
- intoxication;
- internal or external bleeding, as well as an increased likelihood of their occurrence;
- pronounced pain syndrome;
- increased ESR of unknown origin;
- acute infectious and inflammatory diseases;
- metastases;
- progressive irreversible diseases;
- malignant tumors and neoplasms;
- arterial hypertension;
- the presence of a foreign body near large vessels and nerve trunks;
- loss of contact with a person when his mental state is disturbed.
Indications and contraindications for exercise therapy should be taken into account when choosing tactics for treating a patient in a comprehensive manner. This implies that a doctor of the highest level of qualifications should be involved in prescribing physical therapy and monitoring the process of performing exercises.
Pay attention to the list of what not to do with spondylosis:
It is contraindicated to engage in therapeutic exercise during exacerbations of spinal disease; to engage in therapeutic exercise during periods of exacerbation, because this can lead to increased compression of the nerve endings (when the pain is relieved, you can continue doing the exercises);- independently compile a set of exercises and perform them without the knowledge of a doctor;
- perform sudden movements associated with rotations, bending, extension and flexion of the body;
- throw back your head and bend your lower back (this warning applies to people with lumbosacral spondylosis);
- lift heavy gymnastic apparatus;
- load already sore joints with additional weights.
Want to learn more about spinal disease? Read the following articles!
- Read more about the signs of spondylosis deformans here
- Treatment of spondylosis with folk remedies
- Find out how spinal osteophytes are treated on the page
Diagnostics
A doctor can only understand that there is a problem with the spine based on test results. Although at the initial appointment he is required to conduct a full visual examination and palpation. A change in the position of the pelvis, an increase in the natural lordosis and thoracic curvature of the ridge allows one to suspect a displacement. They are usually noticeable without the use of special devices. Also characteristic features for a specialist will be:
- presence of a difference in leg length;
- hypotrophy of the gluteal muscle;
- painful sensations when palpating the lower back;
- deepening of the dorsal groove;
- increased knee reflex;
- pain in the sacrum or perineum;
- complaints of urination or enuresis.
X-rays can confirm or refute the diagnosis. It determines the stage of development of the disease and the cause of its occurrence. MRI or CT are considered more informative techniques, but they are prescribed in some cases to obtain a detailed picture of the patient’s condition.
X-ray is a reliable way to detect pathology