Spinal Degenerative Spondylolisthesis is an extremely common condition that results from spinal arthritis. One vertebra slips on another, and it becomes a mechanical problem that cannot be “fixed”. It may be painless and seen as an incidental finding on x-rays. Or symptoms may include back pain along with buttock, hip, and/or leg pain.
Once diagnosed with degenerative spondylolisthesis, what are treatment options? Here are 7 nonoperative pain management treatment options:
- Ignore it
- Physical Therapy
- Chiropractor Treatment
- Spinal Decompression
- Pain Medication
- Interventional Pain Treatments
- Bracing and TENS Unit
Ignoring the symptoms of degenerative spondylolisthesis is a treatment known as benign neglect. It’s not a fatal condition and will not paralyze anyone, so if they symptoms are tolerable it is OK to simply deal with it until it rises to the level of concern. If you are wondering whether or not there is something you can do to prevent the condition from worsening, the answer is – not really.
There is some thought that nutraceutical substances like glucosamine and chondroitin sulfate may hold off the arthritis that may result in the spondylolisthesis, but this is not a definite.
Physical therapy and chiropractor treatment have been shown to very effective for back pain conditions, especially when they come on acutely (less than one month duration). It may be that your symptoms are an acute exacerbation and if treated with these options, may lessen back to a tolerable baseline.
Spinal decompression therapy is a revolutionary treatment option involving intermittent traction. It is very safe, FDA cleared, relatively painless, and extremely effective. Patients with degenerative spondylolisthesis are OK for the machine unless they have severe osteoporosis or post surgery with hardware.
Pain medications include NSAIDS, Tylenol, neuropathic medications, or narcotics. Over the counter medications according to the manufacturer’s dosage specifications may control the pain very well such Aleve or ibuprofen. Neuropathic medications may include Neurontin or Lyrica. Narcotics should be provided under the guidance of a physician and should only be obtained by one doctor.
Interventional pain treatments include facet injections (facet blocks), epidural injections, or radio frequency ablation. For spinal arthritis or pinched nerves, spinal steroid injections have been shown to be extremely helpful. They are very low risk and may have very high benefit.
Spinal bracing may be very helpful in instances of back pain due to instability with one segment shifting on the segment below. A TENS Unit may keep symptoms at bay when utilized in moderation. It should be used according to your doctor’s recommendations typically no more than an hour at a time with an hour off.