Lumbar is a word derived from Latin, and refers to the lower back, where the spine curves inward toward the abdomen. It starts about five or six inches below the shoulder blades and connects with the thoracic spine at the top and extends downward to the sacral spine. It is built for both power and flexibility – lifting, twisting, and bending. The lower the vertebra is in the spinal column, the more weight it must bear. The Lumbosacral joint allows for considerable rotation, so that the pelvis and hips may swing when walking and running. Lumbosacral joint refers to the point where the lumbar spine meets the Sacrum – (L5 – S1). The sacral region is at the bottom of the spine and lies between the 5th segment of the lumbar spine (L5) and the coccyx (tailbone).
Spondylolisthesis is a break up of two words – “Spondylo” and “Listhesis” – wherein Spondylo refers to the spine and listhesis refers to slippage of the vertebra. There are 33 bones in the spinal column and they are referred to according to the regions they are present- Cervical – Neck, Thoracic – Shoulder/ mid back, Lumbar – Lower back, Sacral and Tail. Spondylolisthesis usually occurs towards the base of the spine in the Lumbar region and is therefore called Lumbosacral Spondylolisthesis. It usually occurs in the L5/S1 region as that is the region which handles the maximum flexibility, weight bearing and rotation.
Lumbosacral Spondylolisthesis is graded according to its severity from Grade 1 – Minimum Severity to Grade 4 – Maximum Severity. Severity being measured by the extent of how much the vertebral body has slipped forward over the body beneath it.
You could have picked it up as a child and it may have gone undetected, but in your adulthood with increased physical activity, along with the wear and tear of life, it may manifest and you would be in enough pain to visit a doctor who would confirm LS. This type of Lumbosacral Spondylolisthesis is referred to as Developmental Lumbosacral Spondylolisthesis – that which may have existed at birth or may develop during childhood, but is generally not noticed until much later. The other type is Acquired Spondylolisthesis, by daily stress that you put on the spine, such as carrying heavy weights and physical sports which cause the spine to weaken. Alternatively, a single or repeated force being applied to the spine can also cause LS.
The initial symptoms which would normally trigger you to visit a doctor would be pain in the lower back, especially after some exertion. This would manifest in the form of pain and weakness in one or both thighs or legs, muscle spasms and immobility.
The treatment for this condition is very similar to that for patients suffering from lower back pain or leg pain. Conservative treatments which include rest, pain medications available over the counter, Heat/Ice packs & Physical therapy are the most preferred. Alternative therapies like Yoga and Ayurveda are also extremely popular for providing lasting pain relief with no side effects. Ayurvedic massages and Therapies like Podikkizhi (Herbal powder massage), Ilakkaizhi (Herbal leaves massage), kativasthi (Pooling medicated oil in the back), Pizhichil (Pouring medicated oils as a stream), Nhavarakkizhi (Massage with rice boiled in medicated milk) and most importantly Kashaya Vasthi (enema with medicated decoctions) and Ksheeravasthi (Enema with medicated milk) are quite effective in relieving the symptoms and aiding pain relief. These therapies also help strengthen the back and prevent a recurrence.