Spondylolisthesis is a condition in which one vertebra slips forward on the one beneath it. It may result from a number of causes, including trauma to the spine or osteoarthritis (wear and tear) of the spine, or it may have been acquired from birth.

The amount the vertebra has slipped forward on the one beneath it may be minimal or very significant.

 
• There may be no symptoms or there may be back pain and the back may feel stiff.  
• If the slip has caused pressure on a nerve root, pain may be felt in the buttocks or thigh.  
• With a major slip, an increase in the bend of the lower back can be noticed (called increased lordosis).

Treatment depends on the severity of the condition and the symptoms. This may range from simple exercises and physical therapy to spinal fusion (hyperlink glossary) to stabilize the spine.

Ankylosing Spondylitis

Ankylosing spondylitis is a type of arthritis that primarily affects the spine. “Ankylosing,” in Greek, means, “causing stiffness and immobility of a joint,” and “spondylitis” means inflammation of one or more vertebrae.

Ankylosing spondylitis causes inflammation of the ligaments and tendons that connect the vertebrae and ultimately results in fusion of the spine. This occurs because the inflammation causes some damage to the bone, and the body heals this damage by growing new bone, which replaces the elastic soft tissue at the back of the spine. This can result in stiffness and pain. In some cases, as the fusion progresses, the spine curves forward, causing a person to stoop.

Ankylosing spondylitis occurs sometimes in people with psoriasis and inflammatory bowel disease.

Stiffness and pain usually begins in the pelvis and at the base of the spine, and progresses upward through the back and to the neck. The back is generally stiff in the morning and improves during the day. Early diagnosis and treatment can control the pain and stiffness.

For more detailed information about Ankylosing Spondylitis, go to Ankylosing Spondylitis.

Osteoporosis And Fractures Of The Lumbar Spine

Osteoporosis is a condition in which bone density and bone strength decreases, making a person more susceptible to fractures. It is a major cause of bone fractures in postmenopausal women and older persons in general.

Because the signs of osteoporosis are subtle and can be easily missed, many people do not know they have osteoporosis until a bone actually breaks. In many cases it is the vertebrae that fracture, causing back pain or deformity. The hip and wrist are also common sites of fractures resulting from osteoporosis.

After menopause, osteoporosis is much more common in women. Bone loss in the spine results in reduced bone strength, and this can easily lead to fractures of the spine.

Pregnancy

A woman’s body undergoes significant hormonal and physical changes during the nine months of pregnancy. For most women, this can lead to back pain as an unavoidable side effect during this time.

Early in pregnancy, certain hormonal changes result in increased joint laxity. As a result, the spine, abdominal and back muscles, and posture of the low back change and become more relaxed.

Poor posture and poor muscle tone prior to pregnancy can affect how the back adjusts. The lumbar (lower back) curve begins to increase slightly as the pelvis tilts backward. This posture begins to influence the weakened and now fatigued lower back muscles. A woman may experience mildly painful spasms, which can be the first sign of a persistent backache in early pregnancy.

As the pregnancy progresses:

 
• The abdomen protrudes.  
• Both gravity and hormonal changes continue to relax the muscles of the low back and abdomen.  
• The increased lumbar curve places stress on the lower back muscles and lumbar spine.  
• The chance of back pain rises significantly with activity.  
• Without treatment, the frequency of muscle spasms and pain may increase.

Back pain during pregnancy can usually be managed with:

 
• Using better posture  
• Learning about body mechanics (proper sitting, bending, lifting, etc.)  
• Using an external brace or support  
• Following a proper exercise plan

Sciatica during pregnancy can also develop from the increased size of the baby itself. The growing fetus can place pressure directly on the nerves of the lumbar area, causing direct pressure and pain. Sciatica almost always goes away after delivery.

Fibromyalgia

Fibromyalgia may cause chronic back pain and is believed to be a result of inflammation of the body’s connective tissue. The condition is characterized by widespread muscle pain, fatigue, and multiple tender points on the body.

Fibromyalgia is more common than most people realize. In many sufferers, pain is present most of the time and may last for years. The severity of the pain goes up and down, and the location of the back pain as well as the generalized pain can vary.

Low back pain resulting from a diagnosis of fibromyalgia is real, but can also be subjective. Many people with this condition find that emotional stress makes the pain worse. Fatigue is also a common aspect of this condition. Chronic pain, along with anxiety about the problem and how to get well, can be fatiguing by itself. In addition, the inflammatory process within the body produces chemicals that are known to cause fatigue.