Learn more about spondylolysis
Spondylolysis
Spondylolysis is a condition affecting the lower back commonly impacting people playing sports with regular hyperextension of their backs.
Suffering chronic lower back pain? Our osteopaths will determine the cause, provide you with a diagnosis and give you a plan to get you back playing again as soon as possible.
What is spondylolysis?
Spondylolysis is a defect or fracture through the pars interarticularis of the vertebral arch of a vertebra. (Gunzburg & Szpalski, 2006) It most commonly occurs in the L5 vertebra but can also occur in cervical vertebra. (Dubousset, 1997) It can lead to the anterior (anterolisthesis) or posterior (retrolisthesis) translation of the vertebra (spondylolisthesis).
In most cases, spondylolysis is asymptomatic. The region of the spine affected will also determine the symptoms present. If there are any symptoms, they often have following characteristics:
- Onset of pain is gradual or acute (after intense athletic activity)
- Possible history of local trauma (recent or historical)
- Intense pain restricts activities of daily living or sporting performance
- Symptoms become aggravated after a stressful event (Syrmou E, 2010)
The Lumbar vertebra are the most commonly affected. Symptoms for lumbar spondylolysis are:
- Focal low back pain with radiation into the buttock or proximal lower limb
- Symptoms can increase with movement specifically lumbar extension or rotation (Gunzburg & Szpalski, 2006)
Management/Treatment
Manual therapy and exercise therapy focus on reducing pain and inflammation, improving strength and flexibility, stabilising the trunk and then return to normal functional movement. (Gunzburg & Szpalski, 2006)
What causes spondylolysis?
Spondylolysis can be a condition present at birth, however can also be caused through injury. When occurring through injury it can either be due to a traumatic fracture or a repetitive stress reaction to the pars interarticularis due to repetitive hyperextension of the back.
Spondylolysis has a higher occurrence in the following activities:
- Baseball
- Military service
- Tennis
- Diving
- Cheerleading
- Gymnastics
- Gridiron Football
- Association Football
- Wrestling
- Weightlifting
- Roller Derby
- Cricket
- Pole Vault
- Rugby
- Volleyball
- Gym
- Ultimate Frisbee (especially during impact from laying out)
- Ballet (Humphreys, 2015)
Prognosis?
With treatment, activity modification, and monitoring, most cases of spondylolysis resolve without further intervention. (O’sullivan PB, 1997 )
Surgery is usually only considered if the condition progresses to spondylolisthesis. Patients with Grade III+ spondylolisthesis who have not responded well to conservative treatment may benefit from surgical intervention (Radcliff, K. et al, 2009)
Possible causes
What causes your pain?
These are some of the other specific conditions that are similar to spondylolysis.
Spondylolysis at The Osteo Collective
How we help.
Assessment
Your practitioner will start by asking you questions about your injury, how, when and why. This will be followed by a physical assessment testing the range of motion of your region of pain, palpating the surrounding muscles and performing some special tests. We will discuss with you our diagnosis and develop a plan with you to help you and your pain.
Treatment
Treatment with our osteopaths is a hands-on approach. After determining where, why and how you have developed your pain we will use a combination of soft tissue techniques, stretching, mobilisation and other joint related techniques. We also consider what you do day to day and develop a home treatment plan for you to implement.
Prevention & management
No one wants regular, recurring nagging chronic pain. Our exercise physiologist is the person to help with prevention and management. Improving your strength, function and flexibility, along with lifestyle changes will help prevent any future re-aggravations. Pilates, yoga, aerobic and strength based exercises will be utilised to help manage your spondylolysis.
Ask us anything
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Which service is best for me? Can you help with chronic low back pain? Do you treat sports injuries? People ask us all kinds of questions before visiting The Osteo Collective. Do you have a question for us? Get in touch.
Where's that from?
References.
Dubousset, J. (1997). Treatment of Spondylolysis and Spondylolisthesis in Children and Adolescents. Clinical Orthopaedics and Related Research, 77–85.
Foreman, P. et al. (2013). L5 spondylolysis/spondylolisthesis: a comprehensive review with an anatomic focus. Childs Nervous System, 209-16.
Gunzburg, R., & Szpalski, M. (2006). Spondylolysis, Spondylolisthesis and Degenerative Spondylolisthesis. Lippincott Williams and Wilkins.
Humphreys, D. (2015). Lecture on Spondylolysis and Spondylolisthesis. Western University Kinesiology Program.
Masci L, P. J. (2006). Use of the one-legged hyperextension test and magnetic resonance imaging in the diagnosis of active spondylolysis. British Journal of Sports Medicine, 940-946.
O’sullivan PB, P. G. (1997 ). Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine, 2959-67.
Radcliff, K. et al. (2009). Surgical Management of Spondylolysis and Spondylolisthesis in Athletes. Current Sports Medicine Reports, 35-40.
Syrmou E, T. P. (2010). Spondylolysis: a review and reappraisal. Hippokratia, 17.
