Could your back pain be caused by spondylolysis? Let's talk about it!

Are you also troubled by back pain? Sometimes you think this is normal, but there may be other reasons behind some pains. Today we are going to talk about a condition that can cause back pain, but we don't talk about it much.

What is Spondylolysis?

Simply put, spondylolysis is a small crack or fracture between two vertebrae in our spine. Did you know that our spine is made up of 33 small bones that are arranged one above the other in a row? We call each of these bones a 'vertebra'. These vertebrae are connected together to form our spine. Doctors sometimes call this condition a 'pars defect' or 'pars fracture' . The reason for this is that this crack occurs in the small bone part called the ' pars interarticularis' that connects the vertebrae. Think of it like a small bridge connecting two vertebrae. That's where the problem occurs. Most of the time, spondylolysis affects the lower part of our back (lumbar spine) . But occasionally, this can occur in the cervical spine, thoracic spine, or even the middle spine.

How common is this condition?

Although there are no exact statistics in Sri Lanka, experts in countries like the United States estimate that this condition (Spondylolysis) affects less than 10% of the population per year. However, it is most common among young children and young adults , especially those who play contact sports.

What are the symptoms of this?

The main symptom for many people is lower back pain . This pain can typically be described as:

• You may feel pain starting in your lower back and spreading to your thighs and buttocks.
• It may feel like a muscle strain in the lower back.
• The pain increases when you engage in any physical activity , and decreases when you rest or don't move much.

But the strange thing is, some people have this condition (Spondylolysis) but don't have any symptoms . They only find out about it later when an imaging test , like a scan, is done for some other reason.

Why is this happening? What are the reasons?

As I mentioned before, the main cause of spondylolysis is damage to the part of our vertebrae called the (pars interarticularis) . Remember, this (pars interarticularis)These are small pieces of bone that connect the vertebrae above and below and help our spine move flexibly. Anything that damages these can cause them to break, or pars fractures . There are several main reasons why these pars fractures often occur:

1. Overuse:

When you do repetitive, stressful movements that put a lot of weight on your lower back, your vertebrae can gradually become damaged. Over time, this damage can accumulate and lead to a pars fracture . For example, if your job involves heavy lifting, you play contact sports , or you frequently injure your lower back, you are at higher risk.

2. Growth spurts:

Some children and young adults have periods of rapid growth, which we call a growth spurt . During those periods, some people can develop spondylolysis . This is because rapid changes occur in the body's skeletal system during that time.

3. Genetics:

Some people are born with slightly thinner vertebrae . This means that their vertebrae are a little weaker than others. These people are also more likely to develop a pars fracture .

Who is at higher risk of developing this condition?

Spondylolysis can actually happen to anyone, but some groups are at a higher risk of developing a pars fracture . These include:

• People who play contact sports : For example, those who play sports like football, gymnastics, and weightlifting .
• Children and young people whose bodies are growing and changing rapidly .
• People of Alaska Native descent : Some studies have found that these people are more likely to be born with thin vertebrae.

What complications can arise from this condition?

The back pain that comes with spondylolysis can reduce your mobility, which is how well and easily you can move around. More importantly, if left untreated , spondylolysis can progress to a condition called spondylolisthesis . Do you know what spondylolisthesis is? It means,Spondylolisthesis is a condition where a vertebra slips out of place due to a crack or weakness in the vertebra. Think of it like a brick in a row of bricks slipping forward. If a slipped vertebra presses on a nerve, it can cause severe pain (sciatica) that feels like an electric shock down your leg. Some people with this condition (spondylolisthesis) may need surgery to reduce the symptoms and return to normal function.

How do doctors diagnose this? (Diagnosis)

A doctor will diagnose spondylolysis by doing a physical exam and doing imaging tests (scans) . He or she will ask you about your symptoms and your medical history. You will need to tell the doctor details such as when you first started feeling your back pain and what you were doing before the pain started.

What tests are being done for this?

Your doctor will use imaging tests to take pictures of your vertebrae and the tissues around your spine. The main ones are:

• X-ray examinations.
• MRI (Magnetic Resonance Imaging - MRI ) scan tests .
• CT (Computed Tomography - CT) scan tests.

What is the treatment for this?

Your doctor will first try to control your pain and other symptoms and give the pars fracture , or crack in the bone, time to heal. Depending on which vertebra is affected and how severe the crack is, you may need treatment for a few weeks to a few months. The main treatments for spondylolysis are:

• Rest : Stay away from sports and other strenuous physical activities that put strain on your back for a while. This will reduce the stress on your spine.
• Medications : Over-the-counter pain relievers ( NSAIDs ) (e.g., ibuprofen, naproxen) can help reduce pain and swelling. However, do not take these pain relievers for more than 10 days at a time without medical advice.
• Corticosteroids : These are powerful medications that reduce inflammation. Your doctor may give you a pill to take orally, or they may give you an injection directly into the area of ​​pain.
• Physical therapy: A physical therapist is a health care professional who helps you move your body better. They can help you manage pain, stiffness, and other symptoms that make it difficult to move. They can teach you exercises to strengthen the muscles around your spine.
• Bracing : Your doctor may recommend that you wear a back brace to keep your spine stable until the pars fracture heals.

Does everyone need surgery?

Surgery is rarely necessary for spondylolysis . Many people get better with nonsurgical treatments. Some people may need surgery to stabilize their spine. In a pars repair surgery , a surgeon can usually repair the pars fracture without having to fuse two vertebrae together ( spinal fusion ). If you need surgery, your doctor or surgeon will explain it to you and tell you how long it will take to recover.

How long will it take for this to heal?

Pars fractures can take up to six months to heal. However, many people with spondylolysis start to feel better soon after starting treatment. Even if your symptoms improve early, follow your treatment plan exactly until your doctor or physical therapist tells you to. It is important to give your spine time to heal completely. Ask your doctor when you can start playing sports or doing heavy lifting again.

Can't this be prevented?

Spondylolysis is usually difficult to prevent, but you can reduce your risk of a pars fracture by following these general safety tips:

• Always wear your seat belt when driving , including the shoulder strap.
• Wear appropriate safety equipment for every activity and sport.
• Check your home and workplace for unnecessary items that could trip you or someone else, and remove them if there are any.
• When picking up something that is high up in the house , always use a tool or device that is suitable for the task . Never climb on chairs, tables, or counters.
• Follow a diet and exercise plan that helps maintain good bone health.
• If you are over 50 years old, or if someone in your family has osteoporosis , talk to your doctor about a bone density test.
• If you have difficulty walking or are at high risk of falling, use a cane or walker.

What happens if I have this condition?

You (Spondylolysis)If there is, nonsurgical treatments such as rest, medication, and physical therapy should help your symptoms improve. These treatments may not completely eliminate the fracture , but they can help you get back to your daily activities as quickly as possible without pain.

When can I start exercising and playing sports again?

Be sure to talk to your doctor before you resume strenuous physical activity. Even if your pain and other symptoms improve, your vertebrae need time to heal. Your doctor will monitor your progress with treatment. As your pain decreases and your flexibility increases, you can gradually return to your normal activities. People recovering from spondylolysis usually need several weeks (and sometimes months) of treatment before they can resume strenuous physical activities, such as playing sports or lifting weights.

When should I see a doctor?

The sooner you see a doctor, the sooner they can diagnose and treat the condition (Spondylolysis) . If you have lower back pain that lasts more than a few days, or is so severe that you can't do your normal activities, see a doctor as soon as possible.

When should I go to an Emergency Treatment Unit (ETU) ?

If you experience a traumatic event, such as a fall or a car accident, go to the emergency room. Also, if you lose feeling in any part of your body or cannot move it, go to the hospital immediately.

What is the difference between Spondylolysis and Spondylolisthesis?

Spondylolysis and Spondylolisthesis are two related conditions that affect your spine.

• Spondylolisthesis is when one vertebra in your spine slips over the vertebra below it, like the brick in a row that I mentioned earlier that slips forward.
• Spondylolysis is a common cause of spondylolisthesis . Spondylolysis causes a fracture ( pars fracture ) in a vertebra, which weakens it and can cause it to slip out of place, causing spondylolisthesis .

Simply put, (Spondylolysis) means a fracture. (Spondylolisthesis) means a slippage of the vertebra due to that fracture. Got it?

What is the difference between Spondylolysis and Spondylosis?

Although the names (Spondylolysis) and (Spondylosis) sound similar, there is a difference between the two, even though they are both conditions that affect the spine. Both can cause symptoms such as pain and stiffness.

• (Spondylolysis)It means a specific injury - that is, a fracture in a part of your spine called the pars interarticularis , which means there is a crack.
• Spondylosis is a general term used to describe the normal degeneration of the spine as we age . This is similar to the degeneration of other joints in our bodies as we age.

That is, (Spondylolysis) is a cause (rupture) , (Spondylosis) is a common condition (due to age) .

Will this condition (Spondylolysis) get better on its own?

Pars fractures associated with spondylolysis usually heal over time. However, it is important to get them diagnosed and treated by a doctor . If you have lower back pain that lasts more than a few days, or is severe enough to interfere with your daily activities, be sure to see a doctor. They can recommend the right treatment to help your vertebrae heal safely and as quickly as possible.

Finally, things to remember (Take-Home Message)

So, spondylolysis is a condition that occurs when small cracks form in the joints of our spine. This usually causes pain in the lower back. The good news is that most people with spondylolysis can return to sports and normal activities once their vertebrae heal and the pain is gone.

Never ignore lower back pain - especially if it lasts more than a few days or is so severe that you can't do your normal activities. It's best to see a doctor to determine the exact cause of your pain and get treatment that will protect your spine and help it heal.

If you have any more questions about this, don't be afraid to ask your doctor or nurse. They will help you. Back pain, spondylolysis, spondylolisthesis, pars interarticularis, spine, sports injuries, physical therapy