Spondylolisthesis is a physiological disorder of the body wherein there’s a defect in the spinal area which contributes to the the vertebrae slips out of place, generally forward. This dysfunction prompts the spine to dip forward at the bottom of the back, causing the shape of the spine to become contorted. Generally, this affects the nerves that inhabit the spinal canal by compacting them, causing pain that can extend all over the lower body along with creating other physiological dysfunctions.
Spondylolisthesis can be caused by a number of problems. If a child you know potentially has spondylolisthesis, it can be due to a birth defect, or another injury related due to overuse called spondylolysis–a stress fracture in the vertebral bone. If you’re an adult, the cause can be due to problems related to aging, such as arthritis and a loss of disc elasticity. Other less common causes that can contribute to spondylolisthesis could be a sudden injury to the area that weakens or breaks the vertebrae, tumors, or any disease that weakens the spine. Excessive sports play such as gymnastics or football in both children and adults is another common cause of the condition.
1. Leg pain
Spondylolisthesis can cause leg pain that extends from the buttocks all the way to the feet. It’s one of the more common symptoms, second to back pain and hamstring muscle tightness. It can mimic and cause sciatica pain. Because there are nerve roots in the neural foramen, a space between vertebrae for which nerve roots travel, spondylolisthesis of the particular area causes the vertebrae to compress or completely move these delicate spaces, thereby affecting nerve roots. These nerve roots travel down the leg.
When compressed or pinched, they can cause cause burning, dull, aching pain that runs all over the legs, generally completely down the back of the leg. The pain can also feel like sharp, sporadic, or even like an electric shock. Pain and discomfort may be felt in both legs or only one leg, depending in what direction the condition pushes on the spine. The leg pain is generally acute but can be chronic and can radiate all over the leg, mostly in the back and stretching downward, but sometimes in the front, affecting the knee. If you typically participate in a higher intensity cardio, this may become increasingly difficult, causing a lot of pain–walking instead is recommended. Leg pain can include the upper thigh, as in the next symptom.
2. Thigh pain
It is typical that pain from this dysfunction will travel to the thigh. If the delicate area in the spine is compressed, it is quite common for pain to spread to the leg, thighs, and buttocks. The pain can range from a chronic dull ache, to a burning or heated sensation, or something closer to pins-and-needles type feeling, or it may mimic a muscle ache. The pain may be felt in one thigh or both, and sufferers normally feel this in the posterior area of the thigh, meaning the back of the legs or hamstrings, but can radiate to the front and to the hip area where the hip flexors and iliacus muscles are, including the buttocks.
3. Buttock pain
Pain may also be felt in the buttocks. Pain that radiates in this area is referred to as radicular pain, and can radiate from the lower back or the hamstrings and thighs. It may feel like a deep pain in the buttock, or be felt where the lower back and buttock area “meet”. It can be painful to sit as much as it is to stand, depending on where the spondylolisthesis area is inside the spine. According to some experts, excessive sitting can aggravate and even help cause spondylolisthesis. It is recommended to take frequent standing and walking breaks, as too much sitting can worsen the pain. However, you’re more likely to feel pain during movement or standing more than sitting.
4. Hamstring tightness
Hamstring tightness is common and usually one of the first signs of having the condition. It is more common with isthmic spondylolisthesis, a fracture of the isthmic caused from a forward slipped disc. Muscle spasms in the hamstring area can occur. You may also find it difficult to do any stretches involving the hamstrings. This includes any exercise that warrants bending over; touching the toes may be difficult to impossible. The pain may radiate around to the front, and can affect your walking gait, causing you to have shorter strides and walk with knees perpetually bent. Stretching the hamstrings may worsen the condition if the cause is spondylolisthesis.
5. Stiffness
You may find it more difficult to move or bend over. The stiffness will generally be felt in the lower back region, the buttocks, and the hamstrings. The feeling can mimic tightness in the hamstrings but be felt extending higher or lower. Because the entire of the body works as one unit, and because spondylolisthesis causes compression of the nerves and tight muscles, the stiffness may be felt all the way to the neck and shoulder area, causing other muscle dysfunction and imbalance issues. Stiffness can include a limited range of motion. It can also be a feeling of tight muscles that need relaxed or massaged.
6. Tenderness
Your neck, shoulders, back, buttocks and thighs may also be tender. When the muscle is pressed upon, it may feel uncomfortable to touch, or even painful. Tenderness is quite frequent in the lumbar (lower back) region and is more frequently relegated to the area of the slipped disc. Tenderness can indirectly affect the way you walk. In some cases, tenderness may only appear when doctors palpate the paraspinal muscles–the muscle group along the spine that support movement–to check for tenderness when in the process of diagnosing a patient with spondylolisthesis. The affected area may be so tender that muscle spasms could occur.
7. Back pain
Though the condition can cause pain extending up the back, lower back pain is the most common sign of spondylolisthesis. Pain is predominantly in the lower back because spondylolisthesis generally affects the last lumbar vertebrae, from the L4 to the S1 joints–sections of the vertebra that make up the spine. The pain will probably worsen after exercise, especially if there are any exercises done that include extension of the lower spine and any exercises that focus on the back or buttocks. Standing for long periods of time or any work overhead can aggravate the pain or cause it. Back pain from this condition is normally chronic and can last several months or until treated.
8. Loss of bladder control
Spondylolisthesis can cause bladder related dysfunctions such as incontinence, or near complete loss of bladder control. You may also find it difficult to urinate or have a bowel movement. This can be caused when there has been long-term damage of the nerves relating to the bladder. Loss of bladder control is rare, but if the condition has progressed exceedingly, it can occur. If you have a herniated disc or spinal stenosis coupled with spondylolisthesis, you can obtain cauda equina syndrome. This syndrome is caused by progressive nerve root damage that will lead to inhibited bladder control or bowel control. If this happens, it’s considered a medical emergency. An advanced symptom like this may need advanced treatment, along with the next symptom.
9. Leg weakness
Your legs may become weaker, making it hard to do everyday tasks such as walking more painful. Acute numbness is another symptom closely related. You may find areas of the legs going numb, even areas of the foot going numb as well. This is a more advanced symptom of spondylolisthesis, and so is more rare. The foot and leg may tingle, as if they’re falling asleep. It may become more difficult to raise either or both legs if this symptom develops. Weight bearing exercises like squatting for instance may also become more difficult to do. This weakness can also extend to the foot.
