Diagnosed with spondylolisthesis? What’s next?

back painspondylolisthesistreatmentarthritis

Jun 21

No, your life is not over.
No, you’re not doomed for pain for the rest of your life.
No, you’re not going to have to be sedentary.

I recently saw patient who was diagnosed with L4-5 spondylolisthesis as a teenager. He is now in his 80s. He has never had surgery and currently has no pain. He’s managed to stay pain free by being healthy, in shape, and with routine exercise.

So if you’ve been diagnosed with spondylolisthesis, do not worry. There are several ways to manage it effectively. Here’s what you can expect and consider next:

1. Consultation with a Specialist

Meet a spine surgeon (neurosurgeon orthopedic surgeon) who can explain your findings and associated symptoms. They can provide a thorough evaluation and discuss treatment options.

2. Conservative Treatment Options

These are usually the first line of treatment and include:

Physical Therapy: Exercises to strengthen the back and abdominal muscles. Specialized exercises can help strengthen the muscles around your spine, improving stability and reducing pain. If you’re having leg pain (e.g., sciatica), traction (decompression therapy) may also help take the pressure of the nerves.
Medications: Pain relievers like NSAIDs or muscle relaxants.
Bracing: A brace can help stabilize the spine. Usually I recommend AGAINST a brace because your body will use it as a crutch and your muscles may weaken. Instead, exercise your back and core muscles to have as an “internal brace.”
Lifestyle Modifications: Avoid activities that exacerbate pain, maintain a healthy weight, and practice good posture.
Techniques such as heat/cold therapy, acupuncture, or massage may help as well.

3. Advanced Treatments

Injections: Injections can reduce inflammation and pain. There’s different types of injections, so if one does not work, do not give up!
Surgery: If conservative treatments fail, surgery may be an option. The type of surgery depends on YOUR specific pathology and what symptoms we are trying to fix. A fusion is NOT the only option! Other options may be motion preservation surgeries such as minimally invasive decompression or the Total Posterior Arthroplasty System (TOPS) procedure.

4. Monitoring and Follow-up

- Regular check-ups with your healthcare provider to monitor the condition and adjust treatment plans as needed.

- Imaging tests, like X-rays or MRIs, may be used to assess the progression of the spondylolisthesis.

5. Education and Support

- Learning about the condition can help you manage it better. Knowing the WHY will help with the HOW.

6. Activity and Exercise

Stay active, eat healthy, and be within the recommended weight for your height.
Engage in low-impact activities like swimming or walking.
Some physicians recommend avoiding high-impact sports or heavy lifting, but my personal philosophy is if you really want to do something that makes you happy, go ahead and do it. Just be aware your pain may worsen.