Norman Allan
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Dr Norman Allan: "Ask the Doctor"

Colin asks about spondylolithesis and Low Back Pain.

Spondylolithesis means that one of the vertebral bodies, usually the bottom one (L5), has slipped forward. It is not uncommon, and it is often asymptomatic.

In conversation the other day, Colin mentioned that his wife has a congenital spondylolithesis and severe Low Back Pain. The back pain is intermittent, but it has been, so far, untreatable (intractable).

The pain in a grade 1 or 2 spondylo is usually due to instability of the posterior elements and muscles "guarding" around this. Ameliorative treatment for such Low Back Pain is very similar to other Low Back Pain treatments. Massage may help. Shiatsu may help. Acupuncture may help.

JKWs exercises (active and assisted) can correct the "neuro-energetic" disfunction in this low back condition, as in others, and is worth trying. Ideally these should be presented to you first hand at our clinic, but failing that you could try following the instructions posted on our website and email us with any questions.

When talking with Colin I asked if his wife had tried acupuncture? She had, two treatments, with no benefit. I pointed out that the failure of any particular therapist is not necessarily a condemnation of the therapy; it may work in other hands. It is probably worth trying again with a competent traditional Chinese doctor.

Back Pain with spondylolithesis can be difficult to treat. Most chiropractic is either irrelevant, or could be dangerous. Two techniques, though, claim to help. The Thompson Technique, with its "drop-table", feel that they can nudge L5 backward with pressure through the abdomen used to set the drop-piece moving. However, there have been no reliable clinical trials. Likewise, there have been no clinical trials of the Gonstead Technique, but I tend to trust the Gonstead Clinic. They are the cream of Chiropractic.

The Gonstead technique speaks of a "base posterior" when the sacrum slips backwards. If the bottom vertebra (L5) has slipped forward we can treat that as a "base posterior" and try to nudge the sacrum forward under the slipped fifth lumbar. If you are near Toronto and dont want to travel, you can some to our clinic for treatment. For state of the art chiropractic treatment of spondylolithesis you might, however, want to travel to the Gonstead Clinic in Mount Horeb, Wisconsin.

from away- if you've already got the left navigation bar this will double it!