Spondylolisthesis has seven syllables. It's hard to pronounce, impossible to remember and can be dreadful to live with. To make it easier to pronounce, we call it "spondy" for short. To make it easier to live with, I've compiled this list.
Here are Five Tips for Living with Spondylolisthesis:
1. PLAN TO GET BETTER
Said otherwise: Avoid catastrophizing.
Catastrophizing is ruminating on pain and anticipating negative outcomes. It tends to make us feel helpless.
It's okay to be scared and it's okay to cry once in awhile. But then you've got to get going again. Your new priority is to get well. This means you've got to get busy creating a dynamic plan of action that will leave you better off than you are now. This may or may not mean that you end up exactly how you were before the diagnosis, but for our purposes "better is better than worse".
Of note: Your doctor is not responsible for you getting better. Your doctor's role is to propose treatment plans. YOU are responsible for figuring out what needs to be done to get better. It is your role to do the homework to be able to discern if your doctors' suggested plans of care are right for you. Which brings us point number two: Get multiple opinions
2. GET MULTIPLE OPINIONS
There's a lot of misinformation about spondy. The biggest myth is that "you will eventually need surgery." This is particularly questionable if your spondy is a 1 or 2.
Oftentimes, it goes like this: Your back hurts, so you get an x-ray and/or an MRI. The radiologist who reads the MRI notes a spondy. They are required to refer you to a specialist, and very often these specialists are also surgeons.
Here's the catch: Surgeons do surgery!
They are trained to solve medical problems through surgical interventions. So it may not be realistic to expect a surgeon to offer you non-surgical options for your condition. That's why it's so important to seek multiple opinions.
Notice that I didn't say "a second opinion". Sometimes two sets of eyeballs just isn't enough. To put this in perspective: We are talking about someone slicing open your back and installing metal hardware in your spine! It's about as huge a deal as you can imagine. Therefore, I maintain that it's a great idea to get "multiple opinions" by doctors who have different hospital affiliations. Remember that surgery is always an option. Try everything else first. Chances are that those other modalities will likely be of great value should you need surgery down the road.
Here's a related story: My son needed surgery on his knee last year, but something wasn't adding up with me. I ended up taking him to nine doctors. NINE!
Seven of those nine medical professionals proposed very different, but equally "creative" surgical hardware solutions. We finally found a couple of "wait and see" concurring recommendations from two of the last three doctors that we saw. Did it cost time and money for those additional office visits? Yes, but it was still a lot safer, cheaper and less traumatic than surgery. By the way, it's been a full year and the boy has returned to sports and is doing great.
3. YOU ARE NOT YOUR DIAGNOSIS
Just because your x-ray or MRI scans show "xyz" does not mean that "xyz" is the generator of pain. Don't be duped in to thinking that your diagnosis definitively explains the cause of your pain. To get an idea of how misleading medical images can be, please read my other article "HOW NOT TO BECOME A VOMIT"
A "v.o.m.i.t." is a victim of medical imaging technology. I know all about this because I am one! When my back was at its worst, I had x-rays and MRI's done which showed three severely degenerated discs, two herniated discs, two scoliosis and a grade 1/2 spondylolisthesis at L5/S1. And yes, I cried...a lot.
I also (unsuccessfully) chased the treatments for those diagnoses for the better part of two years, at great expense and with little relief. In the end, I learned that my pain was not stemming from the herniations or the spondy, but rather from a compressed sacroiliac joint and "modic end plate changes" that are often missed by radiologists.
Now that I've had several years of education and experience, it's evident for me to see the SI joint compression on my x-ray. It's also evident that I had three end-plate fractures, pars defects + inflammation at the facet joints, but none of that was identified by either of the two radiologists, the spine specialist or the spine surgeon.
4. BUILD YOUR TEAM
Start to assemble your team: Look for professionals with diverse educational backgrounds and skill sets who can think out of the box to facilitate your rehabilitation. Remember that your doctors cannot heal you, they can only provide you with the tools with which you can heal yourself. Consider working with professionals from different disciplines: Physical therapy, manual therapy, acupuncture, strength training, feldenkrais, etc. It all works, but none of it works all the time or forever. Remember: There is no magic bullet here. Recovering from spondy is the art and craft of trial and error.
Ask everyone you know to ask everyone they know for referrals. Create a file with every name that comes in, even the ones you don't think you need, want or can afford.
Research has shown that active therapy trumps passive therapy for positive rehabilitative outcomes. This means that therapies in which you are invested in, therapies in which you are actively "doing for yourself" are more effective than passive therapies in which you're having things done to you by another person.
Think of active therapy as exercises and passive therapy as massage or chiropractic.
Speaking of which...if you see a chiropractor, make sure they are using other therapies besides "back cracking". Your vertebra is on the move, so you don't need more mobility, you need more stability!
5. STAY POSITIVE
Keep the faith. Know that the more you focus on pain, the more readily available that sensation becomes. For more on this, check out "Demystifying Pain Sensations"
Net-net, keep focusing on how to get better.
Retrain Back Pain One-to-One Coaching can be invaluable for helping you to successfully navigate your rehabilitative journey.
Yours in health, Dinneen