Management of Back Pain
Causes of Spondylolithesis
There are many causes for spondylolithesis. A vertebra might be defective from the time a person is born, or a vertebra may be broken by trauma or a stress fracture. In addition, vertebrae can be broken down by infection or disease.
Symptoms of Spondylolithesis
Symptoms of spondylolithesis may include:
- Lower back pain
- Muscle tightness and stiffness
- Pain in the buttocks
- Pain radiating down the legs (due to pressure on nerve roots)
- Muscle weakness
Spondylolisthesis is treated with the strengthening of supportive abdominal and back muscles through physical therapy. Acetaminophen or nonsteroidal anti-inflammatory medicines, such as ketoprofen, ibuprofen, Motrin, Advil, naproxen or Aleve may help with pain. Epidural steroid injections may also be effective. For patients who continue to have severe pain and disability despite these treatments, there are options such as decompressive laminectomy, a procedure in which the spinal canal is widened (to provide more room for nerves and a spinal fusion is performed to stabilize the spinal cord), with or without surgical fusion (arthrodesis) of the vertebra, or the use of an implanted device to stabilize the vertebrae in the lower back while permitting more normal movement.
Causes of Cervical Radiculopathy
In cervical radiculopathy, damage can occur as a result of pressure from material from a ruptured disc, degenerative changes in bones, arthritis, or other injuries that put pressure on the nerve roots. In older people, normal degenerative changes in the discs can cause pressure on nerve roots. In younger people, cervical radiculopathy tends to be the result of a ruptured disc. This disc material then compresses the nerve root, causing pain.
Symptoms of Cervical Radiculopathy
The main symptom of cervical radiculopathy is pain that spreads into the arm, neck, chest, and/or shoulders. A person with radiculopathy may experience muscle weakness and/or numbness or tingling in fingers or hands. Other symptoms may include lack of coordination, especially in the hands.
Cervical Radiculopathy Treatment
Cervical radiculopathy may be treated with a combination of pain medications such as acetaminophen (Tylenol), or nonsteroidal pain medication such as ibuprofen (Advil, Motrin), ketoprofen, naproxen (Aleve), and physical therapy. Steroids may be prescribed either orally or injected epidurally (into the epidural space that surrounds the spinal cord).
Physical therapy might include gentle cervical traction and mobilization, exercises, and other modalities to reduce pain.
If significant compression on the nerve exists to the extent that motor weakness results, surgery may be necessary to relieve the pressure.