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Diagnosing spondylolisthesis can be difficult, but treatment through physical therapy, pain management, surgery, or a combination of therapies can be highly effective, with physical therapy being the most common treatment. Spondylolisthesis can be seen most clearly in an x-ray or magnetic resonance imaging (MRI) test as a bone, or vertebra, along the spinal column jutting out of its position in the lineup. While a slipped disk condition is more widely known and involves a slippage of the meat between the vertebrae, with spondylolisthesis, the bone itself skews forward into the lower, or lumbar, region of the spine, sometimes butting into an adjacent vertebra.
When the slip is minimal, an individual may have no symptoms. As the severity or grade of the spondylolisthesis increases, complications with pain, spinal curvature, and nerve damage can occur. Whether the condition was present at birth, occurred through jarring physical activity — such as high-impact athletics or strenuous training — or injury, or develops with aging, treatment is reported to have a high rate of success.
Physical therapy is the most common spondylolisthesis treatment for adjusting the alignment of the vertebrae or for preventing any further movement by strengthening muscles in the back and stomach to help keep the column in place. Therapy also may include leg stretches for individuals who experience radiating cramping or muscle pulling from spinal nerve pressure. Exercises over a period of months may be sufficient in mild cases of spondylolisthesis, while wearing a hard-form brace or body cast for longer periods of time may be necessary for repositioning the column when nerves are being pressed as a result of the slippage.
Injection therapy used alone or in conjunction with physical therapy also has shown to be effective as a spondylolisthesis treatment. Over-the-counter (OTC) medications and anti-inflammatories complement these therapies by lessening the associated discomfort. Stronger pain relievers or muscle relaxants may be given if a patient does not find relief from OTC doses.
Surgery is much less common but is necessary in cases where the vertebral slip is entirely out of alignment or is causing tremendous pain to the patient despite attempts at non-invasive spondylolisthesis treatment. Correcting the condition surgically can involve putting the stray vertebra back in line and fusing the sides with bone taken from the hip or leg. Durable synthetic materials also could be used to achieve the same effect.
While rest and cessation of activity can be prescribed for those suffering from pain, becoming inactive may not be the best course of spondylolisthesis treatment. Muscle tautness gained through targeted and careful physical therapy is helpful in preventing and/or maintaining the grade of vertebral slippage. Those diagnosed with spondylolisthesis and not finding relief with one recommended therapy may find hope in the generally high rate of success and can consult additional medical practitioners before living with chronic pain or making long-term changes to active lifestyles.
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