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Spondylolysis and Spondylolisthesis

What Are Spondylolysis and Spondylolisthesis?

One of the primary roles of the spine is to protect the spinal cord. This means that the spine needs to be strong while maintaining the flexibility required for a movable trunk. While the spine is very sturdy, spinal injuries do occur. Health professionals often use terms to describe and classify injuries of the body, two of these terms that you may have heard are Spondylolysis and Spondylolisthesis.

What are they?

Spondylolysis refers to a stress fracture of the pars interarticularis of the vertebra. This is the part of the vertebra that connects the body of the vertebra with the rest of the vertebra that surrounds the spinal cord. A separation of this fracture where the body of the vertebra is displaced forwards or backwards is called a spondylolisthesis.

Spondylolisthesis is a progression of spondylolysis and is given grades to classify its severity. Both spondylolysis and spondylolisthesis commonly affect the fourth and fifth lumbar vertebrae, found at the base of the lower back.

What are the causes?

Spondylolysis and spondylolisthesis can be a result of trauma with the spine being moved forcefully into extension, particularly in younger people. Certain sports such as gymnastics, football and weightlifting require repetitive backward movements of the spine and this can eventually lead to a stress fracture of the pars interarticularis. Growth spurts in teens have also been known to be responsible for the development of these conditions.

In older adults, common causes of spondylolysis or spondylolisthesis are degenerative changes in the spine due to aging, osteoporosis, infection or even a tumour. Some people have a genetic vulnerability in this area of their spine making them more susceptible to developing spondylolysis and then spondylolisthesis.

What are the symptoms?

Many people with spondylolysis and spondylolisthesis may be asymptomatic, which means they perform their normal activities without experiencing any symptoms. However, when symptoms do occur, common complaints are pain and tightness, much like a muscle strain, spreading across the lower back. This pain may be eased by bending forwards and aggravated by walking, running or leaning backwards.

In more progressive cases of spondylolisthesis, the shift of the vertebral body can cause narrowing of the spinal canal that can lead to nerve compression. This may cause hamstring tightness and even numbness and weakness of the lower limbs, affecting gait and daily activities.

How can physiotherapy help?

Your physiotherapist will work closely with you and any relevant medical professionals to determine exactly what is needed for your particular condition. Severe instability in the spine may require stabilization surgery, however this is rare and in most cases, symptoms of spondylolisthesis can be improved with regular physiotherapy management.

Physiotherapy that focuses on strengthening and improving the flexibility of both the lower back and the abdominal muscles has been shown to have positive effects on both pain and function for those with symptomatic spondylolysis and spondylolisthesis.

Speak to one of our physiotherapists for more information regarding your individual condition. The information in this article is not a replacement for medical advice.

Caboolture Physical Therapy Centre - serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.

When will my injury heal?

When injury strikes, the first thing that most of us want to know is ‘how long will this take to heal?’

Unfortunately, the answer to this can be complicated and requires at least a little understanding of how the different tissues of the body heal. Each of the tissues of the body, including muscles, tendons, ligaments and bone, heal at different speeds and each individual will have some variation on those times as a result of their individual health history and circumstances.

Understanding the type of tissue injured and their different healing times is an important part of how your physiotherapist approaches treatment and setting goals for rehabilitation. On an individual level, a patient’s age, the location and severity of the injury and the way the injury was managed in the first 48 hours all affect the healing times of an injury. Unfortunately, as we age, injuries do tend to heal more slowly than when we are young. Any medical condition that reduces blood flow to an area, such as peripheral vascular disease, can also reduce the body’s ability to heal at its usual rate.

There are some guidelines that can be followed when predicting how long an injury will take to heal based on the tissue type affected. Muscles are full of small capillaries, giving them a rich blood supply, and as such, they have a comparatively fast healing time with 2-4 weeks for minor tears. This time will be extended for larger tears and more complicated presentations.

Ligaments and tendons have less access to blood supply and tears to these tissues generally take longer to heal. Larger or complete tears of all soft tissues, may not be able to heal themselves and in rare cases, surgery may be required for complete healing to occur. Similarly, cartilage, the flexible connective tissue that lines the surface of joints is avascular, which means it has little or no blood supply. To heal, nutrients are supplied to the cartilage from the joint fluid that surrounds and lubricates the joint.

While the different tissues of the body all have different healing times, they do follow a similar process of healing with three main stages, the acute inflammatory phase, the proliferative stage and finally the remodelling stage.

The inflammatory stage occurs immediately after an injury and is the body’s primary defence against injury. This stage is identifiable by heat, redness, swelling and pain around the injured area. During this phase, the body sends white blood cells to remove damaged tissue and reduce any further damage. This stage usually lasts for 3-5 days.

The proliferation stage is the phase where the body starts to produce new cells. Swelling and pain subside and scar tissue is formed that eventually becomes new tissue. This stage usually occurs around days 7-14 following an injury.

The final stage, known as the remodelling stage is when the body completes healing with the reorganization of scar tissue and the laying down of mature tissue. This stage usually occurs roughly two weeks after the initial injury is sustained.

At each stage of the healing process, a different treatment approach is required and your physiotherapist can help to guide you through your recovery. Ask one of our physios at Caboolture Physical Therapy Centre to explain how your injury can be managed best and what to expect in your recovery process.

Caboolture Physical Therapy Centre - serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.

Lumbar Disc Degeneration: Overview, Causes, and Symptoms

What is it?

The discs of the spine sit between the vertebral bodies and act as shock absorbers for the spine. In the lumbar spine the outer part of the disc is made up of thick fibrous rings called the annulus fibrosus and the inner part is a soft jelly-like substance called the nucleus pulposus. The discs in the spine also move to allow flexibility and movement of the spine, particularly in the lumbar spine where they are the largest.

As we age, our discs begin to dehydrate, losing height, elasticity, and flexibility. The result is a spine that can feel stiffer, less flexible and a bit sore with certain movements. While almost everyone will have some degree of degeneration into their later years, not everyone will experience symptoms.

What are the Symptoms?

The most commonly felt symptoms of disc degeneration are stiffness and pain in the lower back. The pain is usually felt over the spine where the disc degeneration has occurred, but also often radiates into the buttock region. In severe cases of disc degeneration, increased wear and tear can cause bony spurs to develop on the vertebral body. These spurs can cause muscle weakness, numbness and tingling sensations in the leg and foot if they place pressure on the nerves around the spine.

How does this happen?

Disc degeneration usually affects people over the age of 50, however symptoms can begin in your 30s. As we age, all of our tissues gradually lose collagen and elastin, in the spinal discs this process results in smaller, less flexible discs. Repetitive activities like bending on the waist to lift heavy objects and prolonged sitting also cause additional wear and tear of the discs and amplify the degenerative process.

How Can Physiotherapy Help?

Imaging such as MRI and XRAY can help determine the level of degeneration that has occurred with increasing accuracy, however in recent years research has shown that the level of degeneration that can be seen In imaging cannot reliably predict the amount of pain a person will experience. This can be confusing for patients and getting scans that show large amounts of degeneration can be a distressing experience, regardless of symptoms, making patients feel helpless.

Physiotherapy can help patients return to their normal activities as soon as possible and regain optimal function for their individual presentation. In addition, physiotherapy helps patients to manage their pain by helping them understand their pathology and, strengthen trunk stabilisers to prevent recurrence of any injury.

The information in this article is not a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.

Caboolture Physical Therapy Centre - serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.

Talking Bones on World Osteoporosis Day

October 20, 2017, marks World Osteoporosis Day. This year the campaign theme is ‘Love your Bones: Protect your Future”.

I’d like to inform the Caboolture community about the health risks of osteoporosis, which are significant, and raise awareness for positive steps towards good bone health.

With one in three women, and one in five men being affected by bone fractures annually, osteoporosis is a world health problem, and it’s growing! By 2022, it is estimated there will be 1.27 million older Queenslanders with low bone mass, which is an increase of 39% from 2012. Among Queenslanders aged 50 years and older in this year’s survey, 14% had osteoporosis and 52% have osteopenia.

In 2017 there will be 88 fractures each day among older adults in Queensland. This year alone, the cost to Queenslanders of osteoporosis and osteopenia is estimated to be around 611 million dollars.

What is osteoporosis? It is a disease that is caused by a loss of bone minerals, making bone become brittle, leading to a higher risk of breaks than in a normal bone.

Can it be stopped? It is possible! Anyone over 50 who has had a fracture from a minor injury should be investigated for osteoporosis. Women over 50 who have one of these fractures are four times more likely to have another fracture the next year. When undiagnosed, Osteoporosis can take a heavy toll on an individual’s independence, mobility, and quality of life, especially when left untreated.

Information is crucial to the prevention of osteoporosis and to achieving a good life with osteoporosis. Treatment often involves mineral supplements, hormone replacement, and medications. But the real quality of life outcomes come from management by diet, exercise, fall’s prevention strategies and training, and the recovery of good movement without pain. For this, the best evidence-based approach is with the combined efforts of a trained Physiotherapist, Exercise Physiologist and Dietician, to get you out of pain, into exercise, functional again in your community, and feeling healthy again.

At Caboolture Physical Therapy Centre, our specialised Osteoporosis Prevention team of Kaye Kerr (Physiotherapist), Alex McGee (Exercise Physiologist) and Cathy Lowe (Dietician), are here to help!

Get in touch today.

 

 

Caboolture Physical Therapy Centre - serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.

Osteoporosis – What is it and how can your Physiotherapist help?

Osteoporosis is a condition characterised by very low bone mass or density. Low bone mass can occur when the body loses too much bone, doesn’t make enough – or both. Osteoporotic bones become weak and fragile and can break from small forces that would normally be harmless.

 

 

But as well as loss of bone density and mass, osteoporotic bones may also be affected by abnormal changes to the structure of the bone matrix, which further contributes to weakness.

Osteoporosis is an extremely common bone disease, and women are more affected than men. As it is a progressive disorder that worsens with age, while the disease process might begin earlier, the effects are usually only noticed and diagnosed in people who are 50 years and older.

What are the Signs and Symptoms?

Often called a silent disease, many people will have no idea that they have the disease, as there are no obvious symptoms. In fact, sometimes the first sign that an individual has osteoporosis is when the first bone breaks. Along with fractures, which are the most serious signs of this disease, osteoporosis can cause the upper back to become excessively hunched (itself often a result of spinal wedge fractures) and there may be widespread pain as bony tissue is increasingly unable to withstand normal forces.

Fractures are a serious problem, especially in seniors. Bone breaks due to osteoporosis occur most frequently in the wrist, spine or hip. When the spine is affected by osteoporosis, people may develop a hunched or stooped posture. This can lead to respiratory issues and place pressure on the internal organs. Osteoporosis can severely impact a person’s mobility and independence, which can have an enormous impact on quality of life.

What Causes It?

As this is primarily a metabolic disorder, there are a variety of things that can cause osteoporosis if they either interfere with the body’s ability to either produce bone tissue or encourage excessive breakdown. This can be anything from gastrointestinal conditions that prevent absorption of calcium, lack of dietary calcium or low levels vitamin D, which is essential for absorption of calcium.

Certain medications may also cause bone loss especially if they are taken for a long time or in high doses. A good example is the long-term use of steroids. Although steroids are used to treat various conditions, it has been proven that steroids can cause bone loss and eventually, osteoporosis.

As bones respond to force and weight bearing by building more bone, having a sedentary lifestyle or doing activities with low impact (i.e. swimming, cycling) can also lead to osteoporosis.

How Can Physiotherapy Help?

Physiotherapy can help you avoid or recover from fractures and improve your overall bone health. Physiotherapy exercises can direct you to safely increase your weight bearing, which can help build bone mass. Balance training is also an important factor as this can reduce the risk of falls. Your physiotherapist can also educate you on how to adjust your lifestyle, at home or at work, to protect your bones and improve your posture.

This information is not a replacement for proper medical advice. Always see a medical professional for advice on your individual condition.

Caboolture Physical Therapy Centre - serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.