Isthmic Spondylolisthesis As a Cause of Sciatica

Isthmic Spondylolisthesis will often lead to sciatica and cause acute back pain. If not treated in time the symptoms progressively worsen over time leading to a degenerative disorder. If frequent and intense back pain and tightness in the hamstrings is your affliction, here is more information on the disorder including what is Isthmic Spondylolisthesis, its causes and symptoms and available treatment alternatives.

What is Isthmic Spondylolisthesis?

Isthmic Spondylolisthesis is a spinal disorder caused due to instability of the vertebral column where one vertebrae slips over the other. The condition commonly occurs in the fifth and sixth vertebrae of the lumbar region and the first vertebrae in the sacral area. The condition is caused due to a genetic defect in almost 4% of the population while other cases of the disorder may be attributed to a host of other reasons.

The causes

The primary cause of Isthmic Spondylolisthesis is a movement in the vertebrae caused due to the fracture of a small bone that connects the two vertebrae. Known as the pars interarticualris, this is a very thin piece of bone with poor blood supply that is prone to fractures due to stress or trauma.

Although not a congenital problem, the fracture occurs at an early age (5 to 7 years); however, the patient may not feel the pain and discomfort for several years.

Adolescent athletes are also susceptible to Isthmic Spondylolisthesis; as a matter of fact, a marked increase has been observed in the number of adolescents suffering from the disorder.

The diagnosis of the condition is done by analyzing the degree of slippage; or the extent to which one vertebral body covers the other. The intensity of the symptoms is directly proportional to the extent of displacement. Different grades are assigned to the disorder based on this factor such as:

  • Grade 1: 25% slippage
  • Grade 2: 25%-50%
  • Grade 3: 50% to 75%
  • Grade 4: More than 75%

Fortunately, most patients suffer from Grade 1 Isthmic Spondylolisthesis

Symptoms of Isthmic Spondylolisthesis

The symptoms of the disorder include:

  • Sciatica caused when the disc break down and limit the amount of space given to the exiting root nerve
  • Pain in the legs, thighs, lower back that radiates to the area around the buttocks
  • Discomfort and intense pain after exercise
  • Leg weakness
  • Muscle spasms
  • Tightness in the hamstring muscles
  • Irregular gait

Treatment Options

In the initial stages when the disorder becomes symptomatic, a physician would usually recommend regular treatment interventions for pain relief that include:

  • Oral steroids for pain relief
  • NSAIDs such as Ibuprofen
  • Physical therapy to stretch the hamstring muscles
  • Chiropractic manipulations
  • Epidural injections used in the area of the pars fracture to reduce inflammation.

Surgery is also an option; however, it is not considered unless the patient has not responded well to traditional forms of pain relief treatment. One of the reasons for the reluctance of doctors to use surgery to correct the disorder is the complexity of the procedure, risks associated with it and the extended recovery period.

However, in some patients Grade 1 Isthmic Spondylolisthesis may progress to Grade 2; in such cases, surgery may the only way to prevent further displacement of the vertebral body and the resultant disability.

The principles of Muscle Balance Therapy can help you strategically assess your individual muscle imbalances and develop a very targeted corrective program to meet your specific needs. More detailed information about this can be found on our website below.