Every patient is different, and each patient’s treatment process may be unique. Your care team may use a combination of techniques to treat spondylolisthesis. At the UK HealthCare Comprehensive Spine Center, our experts work together to create the treatment plan that best fits your specific needs.
Many patients can manage their condition with conservative treatment. You may need to take time away from athletics or hard work to give your body time to heal. In addition, your provider may suggest other treatments.
Physical therapy plays a crucial role in effectively managing chronic back pain. At UK HealthCare, physical therapy is an integral part of many spine treatment plans. Our spine specialists work with therapy experts who specialize in musculoskeletal care. Together, they create a plan tailored for your unique needs.
A physical therapist can:
- Create a personalized exercise plan to enhance your flexibility and range of motion
- Strengthen your core muscles to maintain proper alignment
- Improve your posture
- Educate you on correct movement techniques and modifications to use during pain episodes, helping you to engage in your favorite activities while reducing the likelihood of recurring back pain
Ice packs can reduce swelling and pain in the first days after sciatic nerve pain begins. Apply ice to the affected area several times a day for up to 20 minutes. Place a cloth between the ice pack and your skin to avoid cold-related injuries.
After a few days of using cold therapy to reduce swelling, switching to a heating pad or heat wrap may be helpful. Apply heat to the affected area several times a day for up to 20 minutes. Switching back and forth between applying ice and heat may be helpful.
Back bracing and cervical collars support and stabilize the torso or neck while limiting motion for the spine, muscles and ligaments. Cervical collars are used to stabilize spinal fractures or after surgery, as you are recovering.
Some back braces can be made from breathable elastic or neoprene material that wraps around your torso for targeted support. An adjustable fabric fastener lets you customize the fit for optimal comfort and compression. Other braces, particularly those used for fractures, are rigid and made of hard plastic or metal. These braces minimize spine movement to allow bones to heal. A rigid brace can reduce the risk of nerve damage.
Hard collars are usually made from plexiglass or plastic. They restrict head rotation and side-to-side movement more than softer collars. They often have a chin support to allow the muscles in your neck to relax.
Analgesics, or pain relievers, include a diverse group of medicines that target various pain types. Depending on the type of pain and how severe it is, some analgesics are available over the counter. Others require a prescription.
These are the two main categories of analgesics:
- Anti-inflammatory analgesics: These work by reducing inflammation, a common source of pain.
- Opioid analgesics: These work by altering the brain's perception of pain itself.
These common, over-the-counter medicines target chemicals responsible for pain, inflammation and fever, reducing their production to ease these symptoms.
If over-the-counter pain relievers haven't eased your back pain, talk with your doctor. Muscle relaxants might be an option, but they can cause dizziness and sleepiness.
Muscle knots, or “trigger points,” can cause pain that doesn’t go away with stretching, massage or other treatments. When this happens, trigger point injections may help. During this quick, outpatient procedure, you will lie or sit in a comfortable position while your provider locates the trigger point by touch. A small needle is then inserted directly into the trigger point. A small amount of local anesthetic is injected, which helps relax the muscle and relieve pain. In some cases, a corticosteroid is also added to reduce inflammation. The procedure takes only a few minutes, and patients can usually return to regular activities right away.
During this outpatient procedure, a small needle is guided into a facet joint with imaging. A steroid and pain reliever are injected to reduce inflammation in the joint to relieve pain.
Radiofrequency ablation (RFA) is sometimes used as a minimally invasive treatment option for chronic pain. Also known as radiofrequency neurotomy, this procedure targets specific nerves transmitting pain signals. A thin electrode-tipped needle is inserted near the targeted nerve with the help of imaging guidance (X-ray or fluoroscopy). This treatment uses heat to disrupt the nerve's ability to send pain signals. This can help reduce long-term pain.
If conservative treatments haven’t helped your pain, a targeted injection might offer short-term relief. This injection includes a steroid to reduce swelling around the nerves and a numbing medicine to ease pain right away. While a steroid injection is effective, it's important to note that the pain relief typically lasts for one to two months.
At UK HealthCare, interventional pain management is an integral part of many spine treatment plans. Our spine specialists work with pain management experts specializing in musculoskeletal care to create a plan tailored for each patient's needs.
About 1 in 10 kids with low-grade spondylolisthesis will need surgery. Adults may need surgery if conservative treatment has not improved symptoms after several months and the condition continues to impact quality of life.
During this procedure, your surgical team will remove damaged lamina — part of a vertebra in your spine.
Before your laminectomy, you will get general anesthesia so you will sleep during the procedure. Your surgeon will make an incision in your neck or back and move the ligaments, muscles and tissues to the side to access the lamina bones. During the procedure, your surgeon may remove:
- All or part of the lamina bones on each side of your spine
- The sharp part of your spine (the spinous process)
- Bone spurs
- Disk fragments
- Other soft tissues
In some cases, spinal fusion may be performed at the same time. The surgery usually takes one to three hours.
After your anesthesia wears off, your surgeon will encourage you to take short walks with help (if you didn’t have spinal fusion). You may remain in the hospital for a few days.
After surgery, many patients will experience either some or complete symptom relief, and you should be able to resume light activity after about four weeks.
This surgery is performed to stop movement between two or more vertebrae in the spine.
Before your spinal fusion, you will receive general anesthesia so that you sleep during the procedure. To perform this surgery, your surgeon may access your spine in one of three ways:
- On your back or neck above the spine: You will lie on your stomach, and your surgeon will make an incision over the area and move the muscles and tissues to the side to access the spine.
- On your side: If spinal fusion is being performed on your lower back, you may lie on your side to give the surgeon the best angle to access the spine in that area.
- On the front of the neck: If spinal fusion is on the neck, your surgeon may make an incision on the front part of your neck near the side.
The vertebrae will be fused together with:
- Bone graft placed along the back of the spine
- Bone graft material added between two or more vertebrae
- Implantable cages used between the vertebrae
The doctor may also stabilize the vertebrae with cages, plates, rods or screws until the grafts heal. The surgery usually takes three to four hours.
After your surgery, you will remain in the hospital for three or four days, and you will receive pain medicine to keep you comfortable. You may wear a back brace when you leave the hospital.
After surgery, you will need to stay off work for about four to six weeks as you recover, and you will be limited to very light activity. You may need physical therapy.
If you have tried other pain relief treatments and your spinal pain hasn’t improved, spinal fusion may work as a pain relief option. However, spinal fusion doesn’t provide pain relief for everyone, and it can increase pain.