and try to get an understanding of your back problem and how it is affecting you. Your nerves will also be tested by checking your sensation, your reflexes, and the strength of your muscles. Learn more about physical exams for back problems.
X-rays are often all that are needed to see a pars defect or forward slip of a vertebra. A defect on X-ray does not confirm your back symptoms are coming from the defect. X-rays will help your doctor measure any slippage from possible spondylolisthesis.
Other conditions, such as a herniated disc, may be the actual cause of your symptoms. Your doctor will carefully look for all possible causes of your symptoms, which may involve other tests. The most common tests that are ordered are: an MRI - to look at the nerves and spinal cord; a CT scan - to get a better picture of the vertebral bones; and special nerve tests - to determine if any nerves are being irritated or pinched.
Treatment for spondylolysis and spondylolisthesis is similar to treatments for other causes of mechanical and compressive back pain. Surgery is rarely necessary. Doctors may prescribe rest, including avoidance of sport activities, to help calm symptoms from mechanical back pain. Special braces, casts, or corsets are used to help heal a stress fracture and to ease pain.
Your doctor may have you work with a physical therapist. A well-rounded rehabilitation program assists in calming pain and inflammation, improving your mobility and strength, and helping you do your daily activities with greater ease and ability.
Positions, movements, and exercises are prescribed to reduce pain. Hamstring flexibility is addressed, along with strength and coordination exercises for the low back and abdominal muscles. Sports participants benefit with an assessment of their technique and equipment. Therapy sessions may be scheduled two to three times each week for up to six weeks.
The goals of physical therapy are to help you
- learn to manage your condition and control symptoms
- learn correct posture and body movements to reduce back strain
- maximize your flexibility and core strength
Learn more about spinal rehabilitation.
Medications may be used for short periods to control pain, ease muscle spasms, and help regain a normal sleep pattern (if you are having trouble sleeping). Short periods of bed rest may help with acute painful episodes.
Learn more about medications used to treat back pain.
Surgery is necessary only if conservative treatments fail to keep your pain at a tolerable level. Surgical treatment for spondylolysis and spondylolisthesis must address the presence of mechanical and compressive symptoms.
Nerve pressure may require surgical decompression, called decompressive laminectomy of the lumbar spine. In order to free up or "decompress" the nerves, the surgeon must remove a section of bone from the back of the spine (lamina). The surgeon may also have to remove a portion of the facet joints. The lamina and facet joints normally provide stability in the spine. Removal of either or both can cause the spine to become loose and unstable. When this occurs, doctors will include fusion. Likewise, patients needing surgery for spinal instability due to spondylolisthesis typically require lumbar fusion.
Learn more about lumbar laminectomy.
Learn more about lumbar spine fusion.