Spondylosis, Spondylolisthesis, and Chiropractic

What are Spondylosis and Spondylolisthesis?

Spondylosis and spondylolisthesis can both be extremely painful conditions that might progressively and negatively affect many aspects of a patient’s life. Many treatments are available, both traditional and alternative. One option that is both alternative and natural for treating these conditions is chiropractic care.

Spondylosis is a form of degenerative osteoarthritis of the vertebral column. It often causes degeneration to a point that leads to 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 a loss of control in their bowels and bladder, loss of balance, and “global weakness”.¹

Spondylolisthesis, meanwhile, is a condition of posterior or anterior displacement of the vertebra relative to the vertebrae below (forward slippage is known as anterolisthesis while backward slippage is called retrolisthesis). It can be referred to as “slips” in the lumbar spine. Patients suffering from this may have a stiff back and hamstrings. This gives 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.

In addition to the effects of the condition, compensation knowingly or unknowingly done by the patient could lead to further complications in the long run. It is because of these effects that patients should seek medical treatment at the beginning of signs of unusual symptoms.² These disorders are also different from spondylitis (a vertebra inflammation and “a form of spondylopathy”)³ and spondylolysis (a vertebra defect in the “pars interarticularis of the vertebral arch”). The goal for both the medical practitioner and patient is to get these conditions treated before they reach a dangerous level of degeneration.⁴

Causes and Diagnoses

Repetitive stress injury might be a trigger for spondylosis. Poor ergonomics at home, work, during a commute, using a computer, or by other lifestyle choices that are made regularly and without any idea of their potential side effects are some of the causes of RSI. This is why education of patients about their lifestyle choices should be, in addition to regular treatment, an important aspect of medical care. Although people of any age can get spondylosis, degeneration related to age could also typically cause the condition. Only an MRI, not by X-rays, can scan it. 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, could be a cause of 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). Treatment styles might vary with the patient and category of the disorder’s development in mind.⁶

Medical Treatments and Chiropractic

Typical medical courses for spondylosis include anti-inflammatory medications (NSAIDs, Tylenol, etc.) and behavior/activity modifications. Surgery is and always should be the last option. An invasive course of action should always be saved for only the most serious of situations, as complications might further negatively affect the patient’s condition, in some cases.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 risks and possible side effects that could not help or worsen the condition, alternative therapies may better and more safely benefit people with spondylosis. Yoga, acupuncture, massage, and chiropractic care all can provide patients with relief. The degeneration cannot be cured, but it might be slowed and pain relief could be achieved. Posture modification will help patients benefit even more 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 might help to treat movement compensation and associated tightness. Chiropractors may employ techniques such as “thermal treatment, electrical stimulation and lumbar traction”, and therapeutic exercises.¹⁰

Massage as a Treatment Option

As it is for many physical and mental conditions, massage is often used as an alternative and complementary treatment option to be used along with chiropractic care. This is no different in the case of treating spondylosis and spondylolisthesis. In spondylosis, the “muscles surrounding the spine often become very tense”, which in turn increases the level of pain in the patient. Massage should release the muscles, reducing inflammation in the muscles and pain. Additionally, tight muscles should be worked out and spasms in the muscles should relax, calming both the body and relieving the mind of the stress caused by the spondylosis.¹¹

Massage therapy might also be used in the treatment of spondylolisthesis. The condition may have affected the muscle and other tissues in the spine. Massage, along with physical therapy, can cause muscular strengthening to build stability and promote healing in the weakened muscles. Massage also increases circulation and the release of lactic acid. Lactic acid is a chemical and natural irritant that builds up as a byproduct of muscle use. This lactic acid could further the feeling of inflammation and tenderness, which is why its release could eventually increase the patient’s level of comfort.¹²