Spondylolisthesis: A common cause of low back pain

Spondylolysthesis is a condition where a bone in the spinal column (called vertebra) slips onto the bone below it. The displaced bone then begins to compress on nerves resulting in back pain. However, with some precaution, exercise and medication, patient can manage this condition better.
It is one of the common conditions that leads to low back pain in adults. The condition is most commonly occurred due to abnormal wear on the cartilage and bones such as arthritis. Bone disease and fractures can also cause Spondylolisthesis. Certain sport activities â€" such as gymnastics, weight lifting, and football â€" put a great deal of stress on the bones in the lower back. It can also occur in children usually due to birth defect or sudden injury to spine.
The condition leads to compression of the nerve root, reduces the diameter of spinal canal and prolapsed inter vertebral disc. The main clinical feature is low back pain. During early stage of the disease, particularly in adolescent patients, acute low backache may present. Increased stress on the pars may lead to marked muscle spasm around spine. There may be tightness in the hamstring muscle. Majority of patients present with recurrent episodes of low back pain after exertion. The physical as well as imaging studies can reveal the diagnosis.
The treatment is aimed at achieving maximum correction of the displacement and maintenance of the correction. The grade of slipping of the vertebral body assessed by a physician can determine the approach of treatment.
Brace to support the spine and maintain correction is an important part of the treatment. But it should be worn for very long period to get maximum benefit.
Deep heat is effective in providing relief of pain. Maintain flexion (forward bending) attitude during rest or work is important.
Moreover, some exercise maneuver advised by physiotherapist is also very important to correct the slip.
Surgery is indicated if there is neurological deficit or if pain is disabling or if the slip progresses rapidly.

The write up is compiled by Dr Mohammad Ali, Consultant and Head of Physiotherapy Department, Uttara Adhunik Medical College Hospital.
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