Spondylolysis/Spondylolisthesis? (lower back pain)
Been having a run of bad back pain for the last 4-6 weeks after trying to put a new movement into a weightlifting workout. Went to the general practitioner since I was a couple years past due for a checkup anyway. While there he did some x-rays of my back to see what was up. X-ray clearly showed a small piece broken off the anterior side of L3. I brainstormed the past few years of dumb shit done and drilled down to a time that I stacked up on a pillow line in BC and had to spend the rest of the hut trip laying on the floor. He figured that the piece was stable as it is held in place by ligaments, but figured the trauma required to break it possibly damaged the disc space, and it was irritated from the workout. Fast forward two weeks and it was feeling great again. Good enough that I decided to tackle some yard work that required a ton of shovel time.
Wake the next day after the yard work and the back feels fine, until I lift something that weighed 5 pounds and twisted with it. Bam done. Been pretty much laid up with pain since then (9 days yesterday). Went to see a specialist yesterday and tell him the whole story, he pulls up the x-rays. He sees the "inconsequential" break that the other doc had seen, but said the GP missed the fact that I have Spondylolysis.
The break (Spondylolysis) allows the vertebrae and disk to shift forward and pressure the nerve, hence the pain. He said the definitive treatment is fusing the back, but obviously doesn't want to start there. I started on predisone to try and relieve the swelling and allow the disk to move back into it's space. Once that happens, start PT to learn proper movements and strengthening exercises to protect it from movement in the future.
Radiologists report: Bones: L4 vertebral body limbus deformity. No acute fracture or dislocation. Remaining lumbar vertebral bodies maintain normal height. L5 pars interarticular is defects. 6 mm anterolisthesis of L5 relative S1, which appears stable on flexion and extension imaging.. Intervertebral disc spaces: Mild loss of L3-L4 intervertebral disc space Soft Tissues: Overlying soft tissues unremarkable IMPRESSION: Bilateral L5 pars interarticular is defects, with mild grade 1 spinal listhesis of L5 relative S1. Spondylolisthesis appears stable on flexion and extension imaging. Limbus deformity at the anterior superior corner of the L4 vertebral body, chronic in nature.
So, long story for my question: Based on that report, did I interpret what I was told correctly? Anyone live with this? What is active life like? Have you had "episodes" of pain from doing too much work /lifting wrong? I mean, apparently, unless I broke it from shoveling (unlikely?), then I've been living an active life with it? I mean MTB has caused me lower back pain since that ski wreck, but I'm able to tolerate it with enough stretching and working of the opposing muscles.
Spondylolysis/Spondylolisthesis? (lower back pain)
6 mm is a decent slip, we fixed one yesterday with less than that but it was in a patient with prior L2-5 fusion and we extended it to S1. Work on your core strength and flexibility, avoid spinal surgery for as long as you can.
Oh, posture is everything, don’t let your pelvis roll forward, engage your abs and tuck your butt. You’ll notice a marked difference.
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Spondylolysis/Spondylolisthesis? (lower back pain)
Good luck to those going through severe back issues.
Quote:
Originally Posted by
old goat
My advice re backs--as a patient, not an expert--is to see a PMR (physical medicine and rehab) doc, also called a physiatrist. They can prescribe the proper PT for your particular situation, prescribe non-surgical methods (epidural steroid injections worked for me, or maybe just time), and advise you when surgery is necessary. I wouldn't start with a surgeon. Surgeons love to operate.
Re yoga, often mentioned in these threads. Yoga hurt my back. See PMR first--learn about what body mechanics make your particular situation better or worse. Than you can figure out which yoga poses to do and which to avoid. To some extent the body does what it needs to do to protect the nerves--by altering posture and stiffening certain muscles. The wrong yoga can undo that. For many back problems, including mine, what MU said--tuck the pelvis (posterior rotation), which is why strengthening the abs helps.
quoting for truth, IME. I do not believe my back "issues" are nearly as severe as the OP or others in this thread, but the last severe episode that I had, i visited my GP, who is also a practicing DO (i.e. residency in osteopathic medicine). he sent me to a local physiatrist. By the time I had an appt with the physiatrist, my pain had gone away. we had a consultation and get-to-know you session. following his consultation advice, for me, has worked well for several years (consistent exercise, kelley starett-prescribed running/stretching, posture). I have since used that same physiatrist to recover from a broken foot and related knee issue . The knee/foot issue also introduced me to one of his PTs. Something that has been important to me about the physiatrist and the PT is that they are both athletes, parents, and skiers (one grew up in Olympic Valley and the other in Bishop).
When I was in HS, i got really into mogul skiing. by the time i was in my late teens, i would often have a pretty sore back after a day of bashing bumps, and I had one episode of descending the hill on a backboard after a big huck to flat hardpack landing ass-first (i shit my pants on impact and couldn't sit normally for a few months), which I believe did some undiagnosed damage. i started tele skiing out of curiosity when i was 20, and i've been a full time tele skier for the past 23 seasons. there's a lot more available leg suspension/movement in a tele turn compared to an alpine turn. I still bash bumps and zipperline but on tele skis, and i do not experience the back pain issues. It's something to consider if you need to be easier on your back and still want to ski.
Spondylolysis/Spondylolisthesis? (lower back pain)
I’ve been dealing with back issues similar to many of you.
Compression fracture in L5 after a bad landing off a cliff while skiing in 2004 at 21. A few months of rest and PT followed by my last year of college and an internship at a law firm definitely put me into untrained shape. Next season a fairly “normal” fall caused me to herniate my L5/S1 disc.
This has basically been haunting me ever since. Every few years I’ll get busy at work, sit too much, move too little and I’ll end up tweaking it doing something silly like moving a box or playing Wii bowling (not a joke) and I’ll be laid up for two months while it calms down.
I’m 38 now and hoping to avoid the knife as long as I can although I feel like it’s in my future.
A couple things that helped me: get really flexible in your hips. Lots of time spent talking about hamstring stretching but tight hip flexors and a tight groin are just as bad for me.
My most recent PT also talked a lot about the atrophy of the small stabilizers in my back that big core workout movements had missed. So he gave me a list of small movements and how to isolate those tiny stabilizers. Did a world of difference for me.
Good luck ZZZ. It’s going to suck but I think you’ll get back to a semblance of normal as long as you trust the process and make sure not to rush anything. And switch to wheeled luggage for travel if you haven’t already.
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Spondylolysis/Spondylolisthesis? (lower back pain)
