Do you often get lower back pain? Does it get worse when you exercise, stand for a long time, or lift heavy weights? Many people think that this is just a muscle strain or a sprain . But not all back pain is that simple. Sometimes the cause is a little deeper, and we need to pay attention to it. That's what we're going to talk about today, especially among active young people.
What is Spondylolysis?
Simply put, spondylolysis is a small crack or fracture between two vertebrae in our spine. Now you may be wondering what these vertebrae are. Imagine, our spine is like a tower made up of small bones stacked on top of each other. This is what we call a vertebra. These 33 vertebrae come together to form the entire spine.
Here is a very delicate, small piece of bone where these vertebrae connect to each other. Doctors call this the 'pars interarticularis'. It's like the little piece that connects two links in a chain. A break in that part is what we call spondylolysis . Doctors sometimes call this a 'pars defect' or a 'pars fracture'.
This condition is most common in the lower part of our back, the lumbar spine. This is because it bears the most weight and is subjected to the most bending and twisting of our bodies. However, it can occasionally occur in the cervical spine or the thoracic spine.
What are the symptoms of spondylolysis?
The main and most common symptom of this condition is pain in the lower back. But there are several specific characteristics of this pain. Let's see what they are.
| Symptom | A description about it |
|---|---|
| Lower back pain | This pain often feels like a piece of meat being torn. Many people describe it as a dull ache that comes from deep within. |
| Spreading pain | This pain is not limited to one area of the back. Sometimes it spreads down the buttocks and thighs. |
| Pain that increases with activity | This is the most important thing. This pain increases when you play sports, exercise, bend forward, or lift a heavy object. Also, when you rest and lie down for a while, the pain decreases. |
| Some people have no symptoms. | Surprisingly, some people don't feel any pain or discomfort even though they have this crack in their spine. They only find out about it accidentally when they have something like an X-ray done for another reason. |
Why is this happening? What are the reasons?
Although the exact cause of this condition called Spondylolysis has not been found, several main causes have been identified.
- Overuse and stress: This is the main cause. Doing things that put pressure on the spine repeatedly. Think of someone who bowls fast bowling in cricket, someone who lifts weights in the gym, someone who does gymnastics, or someone who has a job that requires them to bend over and lift weights. Over time, the delicate part of the spine called the 'pars interarticularis' can weaken and cause stress fractures.
- Growth spurts: There is a period of time when young children, especially, suddenly grow taller. During this time, the bones of the body also grow rapidly. This condition can also occur due to the pressure on the spine during this time. That is why it is commonly seen among young athletes.
- Genetics: Some people are born with a slightly thinner spine. This means that the 'pars interarticularis' may be weaker than normal. Such people are more likely to develop this type of fracture than others.
What happens if treatment is not given? (Complications)
Many people think that back pain is a simple problem that will go away on its own in a few days. However, if left untreated, spondylolysis can lead to a more serious condition.
If this crack is not treated properly, it can gradually enlarge and weaken the vertebra. If that happens, the vertebra can slip forward over the vertebra below it.
This condition is called spondylolisthesis . If a slipped bone presses on a nerve that passes through it, it can cause severe pain, numbness, or even sciatica that can radiate down the legs. In such cases, surgery may be necessary. Therefore, it is not a good idea to ignore back pain.
How do you find this, Doctor?
When you go to see a doctor for back pain, he will first ask you about your symptoms. When did your back start hurting, what makes it worse, do you play sports, what your job is, and many other things. Then he will examine your back.
Then, to confirm the condition, the doctor will order several imaging tests.
- X-ray examination: This can often detect fractures in the bones.
- MRI scan (Magnetic Resonance Imaging): This allows you to clearly see not only the bones of the spine, but also the soft tissues and nerves around it.
- CT scan (Computed Tomography): This can see even subtle fractures in the bones very clearly and in detail.
What are the treatments for this?
Although the name may sound scary, spondylolysis is a condition that can often be completely cured without surgery, with simple treatments. The main goal is to control the pain and give the spine the rest and support it needs to heal.
| Treatment method | A short description |
|---|---|
| Taking a break | Stay away from anything that puts pressure on your back, such as playing sports or lifting weights, for a while. This will give your back the time it needs to heal. |
| Medicines | Your doctor may recommend NSAIDs (Nonsteroidal anti-inflammatory drugs) to reduce pain and swelling. However, do not take these for more than 10 days without consulting your doctor. You may also be given corticosteroids (oral tablets or injections) to reduce swelling. |
| Physical Therapy | This is very important. A physical therapist will teach you specific exercises to strengthen the muscles around your back and abdomen (core muscles). When these muscles are strong, they provide good support for your spine. |
| Wearing a belt (Bracing) | Sometimes, the doctor will recommend that you wear a special belt (back brace) to limit your back's movement and keep it stable until it heals. |
Will surgery be needed?
Surgery is rarely necessary. More than 90% of people recover from this condition with other treatments. However, in severe cases, such as when the vertebrae have slipped and are pinching the nerves, or if the pain does not subside after months of treatment, your doctor may consider surgery.
When should I see a doctor?
The sooner the cause is identified, the easier it is to treat and cure. Therefore,
- If you have back pain that lasts more than a few days ,
- If the pain makes it difficult for you to do your normal activities (going to school, going to work, playing sports) ,
See a doctor immediately.
When should you go to the Emergency Treatment Unit (ETU)?
- If your back hurts after an accident (fall, car accident).
- If back pain is accompanied by numbness in a part of the body, or an inability to move that part .
- If you have a condition where you cannot control your urine or stool .
In such a situation, do not waste time and immediately go to the Emergency Treatment Unit (ETU) of the nearest hospital.
Other back problems with similar names
Spondylolysis, Spondylolisthesis, Spondylosis... While these three names sound similar, they actually refer to three different conditions that occur in the spine. Many people get them confused. Let's see what the difference is.
| Status | Simply put... |
|---|---|
| Spondylolysis | A crack or break in a vertebra in the spine. |
| Spondylolisthesis | Spondylolysis is the sliding forward of a weakened vertebra over the vertebra below it. (A slip) |
| Spondylosis | This is quite different. Spondylosis is a general term used for the normal wear and tear of the spine that occurs with age . (Age-related wear and tear) |
Take-Home Message
- Spondylolysis is a small crack in a bone in the spine. It is most common in the lower back.
- Young people who play sports that frequently put pressure on their backs are at higher risk of developing this condition.
- The main symptom is back pain that decreases with rest and increases with activity.
- In most cases, it can be completely cured with simple treatments such as rest, physical therapy, and medication. Surgery is rarely necessary.
- If you have back pain that lasts more than a few days, don't ignore it and definitely see a doctor. Prompt treatment can help you recover quickly.
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