Simeon Asher explains treating Spondylolisthesis
Pain is a signal that something is wrong – it’s part of our ‘protect and defend mechanism’.
Spondylolisthesis comes in many forms, but in almost all cases, it is an extremely painful and discomforting condition for both old and young patients.
Thankfully, this is a condition that can be managed really well with some relatively simple trigger point therapy techniques.
Patients often present with slight forward (flexion) bending (the Phalen‐Dickson sign).
This posture leads to buttock pain as the gluteus maximus and medius and hamstring muscles become similarly engaged in protecting and stabilizing the lower back and hips through their myofascial attachments.
Over time this leads to a ‘chronic tight clenched buttocks’ often with spasms and pain. This buttock clenching tension can be seen clearly during examination. Gluteal muscle spasm and tension can in turn lead to tension in the Piriformis muscles, which engorge and then press upon the sciatic nerve (causing sciatica) or its blood supply (pseudosciatica).
Numbness may be one sided (unilateral) or bilateral. It is usually felt down the back of the legs but this depends on where the spondylolisthesis is located.
Each nerve that exits the spine has a specific radiating pattern or dermatome.
See the illustration above. Often the leg pain is not directly related to pressure on the nerves, but may be coming from muscular trigger points and associated tight muscles.
Tight muscles can press on the delicate blood supply to the nerves and mimic nerve pain (myogenic neuropathy). In these cases, trigger point therapy (see the NAT protocol) can be very, very effective.
About the author
Stuart Hinds is one of Australia’s leading soft tissue therapists, with over 27 years of experience as a practitioner, working with elite sports athletes, supporting Olympic teams, educating and mentoring others as well as running a highly successful clinic in Geelong.
Stuart has a strong following of practitioners across Australia and globally who tap into his expertise as a soft-tissue specialist. He delivers a range of highly sought after seminars across Australia, supported by online videos, webinars and one-on-one mentoring to help support his colleagues to build successful businesses.
In 2016, Stuart was awarded a lifetime membership to Massage & Myotherapy Australia for his significant support and contribution to the industry.
This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.