Spondylolisthesis

Chiropractic treatment has proven to be an effective and holistic option for managing spondylolisthesis, a spinal condition that can cause pain and discomfort.

Spondylolisthesis is characterized by the abnormal sliding of one vertebra over another, and chiropractic therapy offers a non-invasive alternative to conventional treatments. In this article, we will explore how chiropractic can help relieve symptoms and improve the quality of life for those affected by spondylolisthesis.

 

CONTENT:

1. How does chiropractic treatment work?
2. Initial assessment and treatment plan
3. Chiropractic adjustments and symptom reduction
4. Exercises and recommendations for self-care

 

How does chiropractic treatment work?

Chiropractic treatment is based on the principle that a correctly aligned spine contributes to the optimal functioning of the entire nervous system, and implicitly, to the overall health of the body. The chiropractor’s primary concern is to identify and correct structural imbalances in the spine that may affect the normal flow of information between the brain and the rest of the body.

• Correct alignment of the vertebrae

Essentially, the spine serves as the central axis of the human body, and therefore any displacement or misalignment of the vertebrae can affect the entire nervous system. Chiropractors use manual manipulation techniques to return the vertebrae to their correct position. This process, called a chiropractic adjustment, involves applying controlled and directed pressure to specific parts of the spine or joints to restore proper alignment.

• Reducing nerve pressure

Spondylolisthesis can lead to increased pressure on nerves, causing pain and discomfort. Chiropractic adjustments aim to reduce this pressure. This is done by correcting the position of the vertebrae, thus removing any constraint or compression on the nerves. By reducing nerve pressure, chiropractors help improve the transmission of nerve signals and restore normal body functions.

• Stimulation of natural healing processes

Another component of chiropractic treatment is the stimulation of the body’s natural healing processes. Chiropractic adjustments can improve blood circulation and promote the release of endorphins, the body’s natural chemicals that reduce pain and improve well-being. This holistic approach helps speed up the recovery process and strengthen the body’s ability to heal itself.

• Treatment customization

Each patient has individual needs and conditions, and the chiropractic approach adapts according to these particularities. Chiropractors consider the patient’s medical history, specific symptoms, and physical assessment to develop a personalized treatment plan. This plan may include various techniques and exercises to optimize the recovery process.

Initial assessment and treatment plan

In chiropractic treatment, the initial assessment is an essential pillar for understanding the specific needs of the patient and developing an effective treatment plan. The chiropractor begins with a detailed discussion of the patient’s medical history, investigating any previous conditions, treatments followed and relevant health details. This conversation provides a comprehensive picture of the patient’s medical background and provides crucial information for developing a tailored treatment plan.

Development of the treatment plan

Based on the information obtained from the initial assessment, the chiropractor develops a personalized treatment plan. This plan is tailored to the patient’s individual needs and aims to correct the problems identified during the assessment. The main elements of the treatment plan include:

• Regular manual adjustments: The chiropractor uses manual manipulation techniques to adjust the spine and joints, helping to restore proper alignment and reduce nerve pressure.
• Strengthening exercises: The patient can be recommended specific exercises to strengthen the muscles around the spine, thus supporting the healing process and preventing recurrence.
• Pain Management Techniques: The chiropractor may introduce pain management techniques, including ice/heat therapy or relaxation techniques, to relieve discomfort and improve the patient’s quality of life.
• Follow-up schedule: The treatment plan may include regular scheduling for adjustments and periodic assessments to monitor progress and adapt interventions as the patient’s condition evolves.

Chiropractic adjustments and symptom reduction

1. Chiropractic Adjustments – Precise Alignment Technique

Chiropractic adjustments are the core of chiropractic therapeutic intervention and are essential in treating spondylolisthesis. Furthermore, these adjustments involve the use of precise and controlled manual movements applied to the vertebrae and joints. In the case of spondylolisthesis, where one vertebra slips in front of the one below, these adjustments are meant to correct the incorrect position and restore normal spinal alignment.

2. Reduction of vertebral slippage

Spondylolisthesis causes the vertebrae to slip abnormally, which can lead to nerve compression and pain. Moreover, chiropractic adjustments target exactly this problem, providing a non-invasive solution to reduce vertebral slippage. The chiropractor applies specific pressures to guide the vertebra back into the correct position, thereby eliminating tension and excessive pressure on the nerves.

3. Relief of nerve pressure

Excessive pressure on the nerves due to spondylolisthesis can cause pain and discomfort. Chiropractic adjustments not only correct spinal alignments, but also reduce associated nerve pressure. By removing nerve compression, the chiropractor facilitates the transmission of nerve signals, thereby helping to reduce symptoms such as pain, tingling or weakness in the affected areas.

4. Patient experience

Many spondylolisthesis patients report significant improvement after regular chiropractic treatment sessions. They notice a reduction in pain and an increase in mobility in daily activities. Chiropractic adjustments can help restore a normal state of the spine, allowing patients to once again enjoy an increased quality of life and regain control of their physical functions.

5. Continuation of treatment and prevention of relapses

Chiropractic adjustments can have an immediate impact on symptoms, but it is important to recognize that treating spondylolisthesis requires ongoing commitment. The chiropractor will develop a long-term treatment plan that may include regular adjustments, strengthening exercises, and education to properly manage your posture and daily activities. This holistic approach not only relieves existing symptoms, but also helps prevent relapses and maintain a healthy spine in the long term.

Exercises and recommendations for self-care

In the treatment of spondylolisthesis, muscle strengthening exercises are an essential element of the treatment plan. Chiropractors can develop a personalized set of exercises tailored to the patient’s specific needs and fitness level. These exercises aim to strengthen the muscles around the spine. Thus, the affected area is stabilized and unwanted movements of the vertebrae are prevented.

• Spinal Stabilization Exercises

To strengthen support for the spine, patients may be instructed to perform exercises that focus on stabilizing the spine. Stabilization exercises improve muscle strength and control around the vertebrae, helping to maintain proper alignment and prevent relapses. Additionally, these may include exercises with fitness balls, planks, or other movements that emphasize the involvement of core muscles.

• Self-care and prevention techniques

In addition to exercise, chiropractors offer advice to patients on self-care and prevention techniques. These may include:

1. Posture correction: Educating patients about correct posture is crucial. Chiropractors offer practical advice for maintaining balanced posture during daily activities and at work.

2. Muscle relaxation techniques: Chiropractors can train patients in muscle relaxation techniques, which can reduce tension and discomfort in the spinal area.

3. Managing stress: Stress can contribute to muscle tension and deterioration of spinal health. Recommendations for managing stress may include deep breathing techniques, meditation, or other relaxation methods.

4. Monitoring physical activities: Chiropractors can advise patients on appropriate physical activities and how to avoid movements that may aggravate spondylolisthesis. Special attention is paid to how patients lift objects or carry out their daily activities.

• The Importance of Continuity in Self-Care

Self-care exercises and techniques are often an essential part of a long-term maintenance regimen. Continuing exercises and self-care post-symptom improvement reinforces results and prevents relapses in spondylolisthesis. Patients should incorporate these practices for a healthy spine and to sustain the long-term benefits of chiropractic treatment.

In this article we will analyze the full range of surgical and non-surgical treatment options for spondylolisthesis.

Degenerative spondylolisthesis is relatively rare in other segments of the spine, but can occur in two or even three segments simultaneously.

Each segment of the spine consists of vertebrae, intervertebral discs, and joint facets. The intervertebral disc acts as a shock absorber between the vertebrae, while the paired articular facets restrict movement. They allow the spine to bend forward (flexion) and backward (extension), but do not allow a rotational movement.

As you age, joint facets can become incompetent and allow for too much flexion, allowing one vertebral body to slide on the other.

CONTENT:

1. Changing daily activities
2. Chiropractic therapy
3. Epidural injections

 

Changing daily activities

Patients can change their activities so that they spend more time sitting in a chair and less time standing or walking.

The change in activities generally includes:

• A short period of rest (for example, one to two days of rest or relaxation in a folding chair);
• Avoiding standing;
• Avoiding walking for long periods of time;
• Avoiding dangerous physical exercises;
• Avoid activities that require column extension.

 

If changing activities substantially reduces the patient’s pain and symptoms, this is an acceptable way to manage the condition in the long run.

Applying cold compresses, applying heat or pain medications can help with this approach, especially after walking or any strenuous activity, but it does not solve the problem of long-term pain 100%. For patients who want to be more active, the fixed bike in the gyms is a reasonable option, because it is an activity performed in a sitting position and should be tolerated.

Another option is aqua gym – gymnastics performed in the swimming pool with warm water – because the water provides support and buoyancy, and the patient is comfortable to perform flexion-extension movements to strengthen the lumbar muscles.

Many patients benefit from a physical therapy program in which certain exercises are performed gradually and controlled, which have the role of strengthening the lumbar muscles in order to maintain and / or increase the degree of mobility and flexibility, which, in turn, tends to to alleviate pain as well as to help the patient maintain his ability to function actively every day.

 

Chiropractic therapy

Chiropractic therapy helps you to reduce pain by mobilizing painful joint dysfunction. The first symptom identified by the chiropractor in case of spondylolisthesis is pain in the affected region. It improves in flexion, and is accentuated in extension, this posture favoring the degree of sliding.

The contracture of the paravertebral muscles is present, to which the contracture of the gluteal muscles can be associated, respectively the contracture of the thigh muscles. Slipping can also lead to compression of the roots of the spinal nerves, in which case symptoms such as numbness, tingling, loss of reflexes, even muscle atrophy along the path of the affected nerves may occur.

The treatment of spondylolisthesis aims to align the slippery vertebrae, which will remove pain and muscle contractions, and stop the negative effects on the limbs through which the pressed nerve passes (numbness, tingling, muscle atrophy), thus ensuring the patient’s return to daily activities.

These results can be obtained by chiropractic, a method successfully used in the treatment of spondylolisthesis, which consists of various manipulations performed on the spine by elongation, torsion and cracking.

Through these manipulations, after several sessions, the slipped vertebra is progressively repositioned, resulting in the disappearance of the mentioned symptoms in a relatively short time, acting directly because of these symptoms.

 

Epidural injections

Injections are effective in reducing a patient’s pain in up to 50% of cases.
An epidural injection of steroids works to relieve the patient’s pain and can be done a maximum of three times a year. The length of time the lumbar epidural injection can be effective is variable, as pain relief can take a week or a year.

Spondylolisthesis is the anterior slip of one vertebra to the rest of the vertebrae, more precisely the vertebra changes its initial position and leaves the alignment of the other adjacent vertebrae.

Spondylolisthesis is classified according to the causes of its occurrence and is of five types: congenital, isthmic, degenerative, traumatic and pathological.

 

CONTENT:

1. Causes of Spondylolisthesis
2. Symptoms of Spondylolisthesis
3. Treatment of Spondylolisthesis

 

Causes

• congenital defect in the spine (usually occurs a few years after birth);
• acute trauma to the back;
• exaggerated repetitive extensions (common in certain sports);
• muscle atrophies;
• degenerative diseases of the spine.

 

Symptoms

Other people suffer from pain, especially under stress and during certain movements. The pain caused by spondylolisthesis can spread from back to front in a belt shape. There is also a feeling of instability in the spine.

Especially in the morning, when the back muscles are relaxed, the pain is strong. In severe cases, there are reflex, sensory and motor disorders, which can extend to the legs. These symptoms occur when the vertebra squeezes a nerve root through a spondylolisthesis.

However, there are no specific gliding symptoms, as the symptoms may be similar to those of other back problems, such as herniated discs.

In the congenital form of patients with spondylolisthesis, usually the symptoms are mild or mild, being a slow progressive process. So the nerves have the opportunity to adapt to changed circumstances.

 

Treatment

Physical and rehabilitation therapy
It should not be initiated until after a period of rest and once the pain with daily activities has diminished. Physical regimens reduce the stress by extension of the lumbar spine and promote a nonlordotic position. It consists of exercises for stretching the abdominal muscles, wearing harnesses and strengthening the lumbodorsal fascia.

Thoracolombosacral orthosis trimming provides relief for those who do not respond to rest or whose daily activities cause symptoms. This type of rod is effective for patients with less than 50% slip. The stem is worn for 3-6 months. If the slip is below 50% but the patient is symptomatic, non-interventional therapy is recommended: stretching exercises, antilordotic rod, modification of activities. If the pain continues, spinal fusion is recommended.

Surgical therapy
Surgery is indicated for immature skeletal patients with slipping over 30-50% because they are at risk of progression with neurological deficit and persistent pain. If the pain does not resolve in 6-12 weeks with rest and immobilization, surgery is recommended. Spondylolysis with low-grade spondylolisthesis can be treated noninterventionally.

Intervention options include direct repair of spondylolytic defect, fusion, reduction and fusion, and vertebrectomy. The best results are seen in patients with lithic defect. Disc degeneration is a relative contraindication. Slips over 2 mm decrease the success of surgical repair.

In situ fusion at the affected level is the standard criterion for surgical treatment for most patients in whom conservative therapy fails. In situ fusion is recommended for patients with low-grade, persistent, symptomatic spondylolisthesis and for those who are not candidates to repair the defect.

Decompression and fusion are performed in cases of hard compression in the presence of intestinal or bladder dysfunction or significant motor deficits. Decompression is never performed without concomitant fusion. Fixing the pedicles with screws allows rapid mobilization and early ambulance after decompression and fusion. Fixation can be beneficial in repairing pseudoarthrosis and preventing progressive slipping.

The reduction of spondylolisthesis is performed by the closed or open procedure. The reduction serves to correct the lumbosacral kyphosis and decrease the sagittal translation. Vertebrectomy can be used to treat spondyloptosis and as an alternative to reduction or fusion in situ. The postoperative rate of neurological deficit is 25%