Grade 1 lower lumbar spondylolisthesis - neck stiffness?

[Jollie93]

Just wondering if anyone with grade 1 lower lumbar spondylolisthesis has neck spasms/discomfort?

I just got diagnosed by MRI a week ago, and not sure if I've caused the neck issues myself or not. As soon as I found out I got a back support cushion/a cuddler cushion thing and completely changed my posture and sat upright with perfect posture all night and the neck issues started that night. Then kind of continued trying to have perfect posture for the next few days but the neck spasms were getting worse, my partner said I was walking like a ventriloquist. (I got super paranoid about my posture because it's always been bad and didn't want to exacerbate things).

I stopped using the back support cushions the last two days to see if it helps with the neck spasms but there hasn't been much change yet.

I've been doing neck exercises to try and relieve it which helps a little bit, but it's particularly bad at night and I can't relax at all when it gets all stiff and it feels like there's pressure. When I go to bed and lie with my head flat on a pillow it seems to disappear and doesn't impact sleep at all. Thought of going to the GP today but I already have an appointment on Tuesday so just trying to calm myself down until then, I know there's not much they can do for me anyway.

Is this a normal symptom? Does anyone have any advice for managing it? I'm managing the actual back pain just fine with heat pads and the occasional ibuprofen, but I dk why the neck issues are freaking me out. (I have quite bad health anxiety at the moment if you can't already tell)

[Libluce68]

I have grade 2-3 Spondylolthesis acquired following the feature of facet joints when in my 30s - I’m now in late 60s - I find the slightest change to my posture can send it into spasm and I’m prone to pain in other areas of the spine - my GP sent me to a physio and she tried to change my posture causing shooting pain from the base of my spine along the spine to my neck - it’s tricky it could be the changes you’ve made in sitting or you could have slept differently but from my experience I know any changes to posture can kick off spasms - I manage my issues with swimming - I swim better than I walk - hope you manage to get some relief x

[Jollie93 in reply to Libluce68]

Thanks for your reply! I think the changes to my posture was the issue, the neck issues have calmed down quite a bit, think I'll need to make postural changes over time rather than all at once. If you don't mind me asking have you managed it 30 years with only exercise and physio? Just wondering because one of my doctors mentioned surgery and I thought that was extreme for grade 1 and something I'll avoid forever if I can 😂 x

[Libluce68 in reply to Jollie93]

I fractured my facet joints in 1992 - treatment then was a plaster jacket for 6 months and rest - I went from running 40 miles a week to nothing - surgery was offered but success rate was poor so I just kept going with pain killers (morphine etc) and swimming (I was a British squad swimmer/runner) I swam better than I walked - the back issues caused me problems/curtailed my life and still do but im pragmatic and just get on with things - in 2008 I had a cycling accident (car hit me from behind at nearly 40mph) and I lost both knees/accelerated arthritis - an MRI on my spine showed it had naturally fused at level 3 but I had also acquired scoliosis and since the accident I’ve lost a good 3 inches in height - I had to stop Naproxen and find other ways of managing pain without meds - I trained as a psychologist specialising in pain management and focus on positives as much as possible - not always easy I admit and have adapted my life to manage - much of it is about accepting this is who you are - I still swim knocking out 30 to 50 lengths of front crawl 3-4 times a week - that helps in keeping my core strong and it worries me as I get older if I have to stop the swimming - you have to do what’s right for you but before any surgery really research and ask lots of questions - I wish you well x

[lupus_01]

You have to remember your back/neck is used to a particular position and will not enjoy a new although posture correct position. It can take weeks/months to adjust.I take turns when trying a new chair/bed/pillow. So one day new one day old.

[Jollie93 in reply to lupus_01]

Thanks for your reply! 😊I'm trying the day on day off approach now and it does seem to be helping, think it was just too much at once. I also hadn't considered how long it might take to adjust

[cyberbarn]

It sounds like you have tired to change your posture and that has made things worse.

My lower back ( I have lumbar spondylolisthesis too) got a lot worse when I went to see a physio about my neck pain. She wanted me to have a 'better' posture, stand and sit straight, be like a soldier. They now think that was what made my lower back worse.

There has been a change in physio theory recently. They now think that there is no such thing as 'good posture'. The right posture is the one that doesn't cause pain.

My son recently saw an advanced practice physio for a diagnosis and at the end of the session my son asked if he should be doing some exercises to improve his posture. The physio said no, we don't do that anymore, it can cause more problems.

One of the problems with physio research is that it was often done on elite sports athletes which are not representative of the general public.

So if you are changing to a posture that hurts, and is causing more pain, or if you are doing exercises that cause more pain, then stop.

It would be better to see a good physiotherapist to find out what 'good' actually looks like.

[Jollie93 in reply to cyberbarn]

Thanks for your reply! That's interesting and is good to know, I just assumed the status quo would be sitting/standing like a soldier too 😂 It seems common then but still a shock that posture changes can cause symptoms to get so much worse, but thankfully things have settled a little since I've gone back to slouching a bit. I'm still waiting to see the neurologist and to get a referral for physio, the spondylolisthesis was actually picked up when I was seeing a gynaecologist and mentioned new back pain. But may even be able to self refer since I have the basic info/diagnosis x

[cyberbarn in reply to Jollie93]

I think they were a bit premature to suggest surgery! I have have mild spondylolisthesis by a rheumatologist, and was offered nothing for it at all. If fact my first rheumatologist didn't even bother to tell me. I did see (online during covid) a physio at the university I am attending (doing a PhD in medical reasoning, in my 60s, better late than never!) and she said mainly it will be strengthening the muscles so it doesn't get worse. It seems the only reason they would do surgery was if it cauda equina syndrome which is where it you lose feeling in the saddle region as well as bladder control. This is a medical emergency.

I try to do some of the exercises that the physio suggested to strengthen my abdominal and lower back muscles or my core, but that's all. I get some sciatica but it is not all the time. And it might be caused by something else and not the spondylolisthesis. My GP is only worried about cauda equina syndrome, anything else is self management with pain killers. Most of which I can't take but that is another story!

I stopped completely doing the whole posture change. It just isn't recommended anymore. It could be possible for a very skilled physio to get the bone back into place, but it would only slip out again if your muscles aren't strong enough to keep it in place. Changing your posture isn't going to make it better, strengthening your muscles around that area might stop it getting worse. And it may well not be your posture that caused it, for example people who are hypermobile perhaps because of hypermobile EDS/HSD are more prone to it. The ligaments that hold the spinal bones in the correct position don't do their job properly and the bones can slip out of place.

So you really need to see a physio, and you should be able to self refer in the NHS rather than wait for someone to refer you. Although you might consider going private if you have the money. Here is a quote from a clinic, "There’s no such thing as perfect or imperfect posture. Everyone’s body is slightly different. Don’t stress about having exactly perfect posture all the time. In fact, some studies have found that commonly considered poor or bad posture has more to do with self-esteem and thinking you look good rather than staying healthy or preventing pain. What that means is, you can be mindful about sitting or moving safely, but try not to worry about it all the time."

So hot water bottles when the sciatica kicks in, paracetamol, and remember to make sure I keep my core working, and that's it. Other than that it isn't a problem. Some people will have spondylolisthesis and never know!

[cyberbarn in reply to cyberbarn]

Here's a link to an article in The Guardian about posture theguardian.com/lifeandstyl...