Integrated Pain Management



refers to the forward displacement of a vertebra in most cases the 5th lumbar vertebrae. This condition occurs commonly after a fracture or a break. The backward displacement is called retrolisthesis.

The slips of the vertebrae occur in the lumbar spine and Spondylosis is the most common cause of Spondylolisthesis and this condition should be distinguished from slipped discs. In some cases, this might lead to the squeezing of the nerve roots or the spinal cord and this is what leads to pain and weakness in one or both of the patient’s legs.


Some patients might lose their bladder and bowel control and this is a case that requires urgent medical attention.

In some situations, a vertebra might slip out of its normal position and the individual will not have any symptom or the symptoms will appear years later.

When symptoms kick in, the patient might experience pain in their buttock or lower back and the muscles of their legs might feel weak or tight and this leads to a limp.

Signs and Symptoms

A patient affected by Spondylolisthesis may experience the following symptoms:

> Pain that starts from the lower back and runs all the way to the leg ( sometimes one and in other cases both legs) 

> Difficulty in walking 

> Buttock or back pain Weakness or numbness in one or both legs 

> Back, leg, or buttock pain that worsens with a twist or a bend.

> Tightening of hamstrings and stiffening of the back which result in altered posture and gait 

> Compensatory changes leading to a forward lean or a semi-kyphotic posture 

> Loss of bowel or bladder control (usually in rare cases which are considered serious)

Sneezing and coughing can intensify the pain and some patients have reported slipping sensations when moving to upright positions.

In most cases, trying to stand and sitting are painful experiences. As aforementioned, there are Spondylolisthesis cases that will have no symptoms for a long period of time.



A medical practitioner will observe the patient’s back x-rays if they suspect that the individual is suffering from this condition. An x-ray will show if the patient has a fractured or cracked vertebrae or when there is a slip. A CT scan is used in the diagnosis to help in identifying the exact location of the damage and make treatment fast and easier.


The first step in treating Spondylolisthesis is the discontinuation of the activity that led to the damage. To assist in pain relief, nonsteroidal anti-inflammatory drugs such as ibuprofen can be used.

Aspirin should not be given to anyone under the age of 20 years as this might increase the risk of a serious illness referred to as Reye syndrome.

Medical practitioners will recommend physical therapy such as exercise which is believed to build back and stomach muscles or what is referred to as core strengthening. Weight loss in overweight people might also help in managing the condition.

If there is extreme pain and the spinal cord or the nerve root is damaged by the Spondylolisthesis surgery can be used to treat the patient. The surgery performed is aimed at removing tissues or bone pieces that are involved in the compression of the nerves or the spine.

In some cases, the surgery might be performed to fuse the bones back into position. In other cases, the fusion of the bones and the decompression of the nerves or spine are done in the same surgery.

After these surgeries, the patient might be required to wear a back brace or a cast for sometime. Later on they should take part in rehabilitation therapy for easier movement and stronger muscles.