Lower Back Pain – Spondylosis, Spondylolysis, Spondylolisthesis – What’s the Difference and How Remedial Massage can help!

Causes of lower back pain

It’s not as tricky as you may think. If you are curious or have been diagnosed with one of these, read below to find out more and how Inner Sight can help!

Spondylosis: refers to when you have degenerative osteoarthritis (OA) of the spine- this essentially means that the space between your vertebrae narrows as the protective cartilage that cushions the ends of the vertebrae wears down with age.

With time, you may notice you have more of a flexed (forward bending) posture. Individuals suffering from this may experience lower back pain, leg pain, and/or numbness when standing or walking; symptoms may only seem to improve with sitting or lying down.

Spondylolysis: refers to a stress fracture defect in the pars interarticularis of the vertebrae (commonly found in the L4/L5 region).

This is usually caused by repetitive stress or trauma at the Lumbar spine from strenuous activities involving excessive twisting/rotating or back bending (ex: gymnastics, dancing, wrestling, and football).

Symptoms may or may not be present initially, but as the injury progresses, these individuals may complain of pain as they bend backward or pain with general activities.

Spondylolisthesis: often refers to the progression of a spondylosis injury, but it may also be congenital or idiopathic in nature.

Spondylolisthesis is defined as the displacement of one vertebra over the vertebral body below it (commonly known as a “step off” or “slip” at the L5/S1 level); individuals may even notice the presence of a bump by the area of the slippage.

There are 5 different grades of this slippage, and it’s defined by the extent to which the vertebral body has slipped:

  1. Grade I: O-25%
  2. Grade II: 25-50%
  3. Grade III: 50-75%
  4. Grade IV: 75-100%
  5. Grade V: > 100%

Individuals with this may complain of localized pain that may come and go with certain activities, and this may be the most notable when bending backward or forward at the affected segment. They may experience radicular pain down to one or both legs as the vertebrae slide and cause compression of the nerve root below, tense hamstrings, loss of bowel/bladder (rare), and difficulty with balance or walking.

What can we do?

First, consult with your Doctor to obtain an MRI, CT, Bone scan, or X-ray to confirm the diagnosis and determine the extent of the injury.

Treatments can involve both operative (surgical) or nonoperative/conservative management (Physiotherapy, Remedial Massage, and NSAIDs/analgesics). Generally, surgical interventions are reserved for those with significant symptoms or failure of conservative treatments.

Spondylosis: conservative management involving aerobic exercises such as biking and general strengthening and stretching of your whole body has been correlated to greater quality of life among adults with lumbar osteoarthritis. In addition, maintaining good posture throughout and maintaining postural muscle strength can help to decrease pain and promote proper muscle length-tension relationships.

Spondylolysis/Spondylolisthesis: as with any fracture, your body will need time to heal. This means 4-8 weeks (or longer) of rest from high-impact activities such as sports and lifting heavy items. Your Doctor may also recommend pain medications such as NSAIDs or steroids to help reduce pain and inflammation. During this time, Remedial Massage can help facilitate the healing process, reduce pain, and help you navigate through your everyday activities.

In addition, with both spondylolysis and spondylolisthesis, studies have shown that specific strengthening of the deep multifidus and transversus abdominis can be beneficial for spinal instability that commonly occurs.

Together with Remedial Massage, exercises to promote the full spinal range of motion and lumbar strengthening exercises have been proven to be a successful treatment option for decreasing pain and functional limitations.

At Inner Sight we help people manage and reduce the pain associated with all lower back pain with Remedial/Deep Tissue/Sports massage.