Spondylosis and spondylolisthesis can be extremely painful conditions. Many treatments are available, including chiropractic.
What are Spondylosis and Spondylolisthesis?
Spondylosis is a form of degenerative osteoarthritis of the vertebral column. It can cause muscle weakness, motor and sensory disturbances, and paresthesia and pain, due to the pressure on the nerve roots. In a severe case, the patient may end up with loss of bowel/bladder control, loss of balance, and “global weakness”.1 Spondylolisthesis is the posterior or anterior displacement of the vertebra relative to the vertebrae below (forward slippage is anterolisthesis and backward slippage is retrolisthesis). It can be referred to as “slips” in the lumbar spine. Patients suffering from this may have a stiff back and hamstrings, giving them a waddling gait and causing them to lean forward. This leads to “shocks of shooting pain” from the buttock down to the lower leg, via the sciatic nerve. There can also be numbness and tingling.2 These disorders are different than spondylitis (a vertebra inflammation and “a form of spondylopathy”)3 and spondylolysis (a vertebra defect in the “pars interarticularis of the vertebral arch”)4.
Causes and Diagnoses
Repetitive stress injury can trigger spondylosis. RSI can be caused by poor ergonomics at home, work, during a commute, using a computer, or other lifestyle choices. It can typically be caused by degeneration related to age, although people of any age can get spondylosis. It can only be scanned by MRI, not by X-rays. Other forms of diagnostic tests include Lhermitte sign (a “feeling of electrical shock with neck flexion”) and Spurling’s test, where head rotation with pressure can show “neck or shoulder pain on the ipsilateral side”.5 Repeated hyperextension, such as the type shown in regular athletes, can cause spondylolisthesis. Heredity also plays a role in that it runs in families. There are 5 different types of spondylolisthesis: “Dysplastic, Isthmic, Degenerative, Traumatic, and Pathologic”. These categories refer to how the disorder developed (congenitally, during childhood years, during elder years, from injury, or via disease).6
Medical Treatments and Chiropractic
Typical medical courses for spondylosis include anti-inflammatory medications (NSAIDs, Tylenol, etc.) and behavior/activity modifications. Surgery is a last option.7 For spondylolisthesis, the treatments are similar, and there may also be steroid injections and the inclusion of orthosis devices.8 Because medications and surgeries introduce risk, alternative therapies may benefit people with spondylosis. Yoga, acupuncture, massage, and chiropractic care can provide patients with relief. The degeneration cannot be cured, but pain relief can be achieved. Posture modification can help patients benefit from the adjustments, flexibility exercises, and decompression treatments (i.e., traction and manual mobilization).9 In the case of spondylolisthesis, chiropractic care can also help with posture and flexibility, and it can help treat movement compensation and associated tightness. Chiropractors may employ techniques such as “thermal treatment, electrical stimulation and lumbar traction”, and therapeutic exercises.10