Isthmic spondylolisthesis occurs when one vertebra slips forward in the spine over the one below it due to a small break in the vertebra. The break occurs on the vertebral isthmus, the area that connects the front and back of the vertebra.

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Isthmic spondylolisthesis occurs when a fracture of the isthmus causes one vertebral body to slip forward on top of the vertebral body below it. Watch: Isthmic Spondylolisthesis Video

Sciatica can be caused by isthmic spondylolisthesis if the condition results in nerve root impingement. In most cases, sciatica caused by isthmic spondylolisthesis affects the L5 nerve root.

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When treating sciatica resulting from isthmic spondylolisthesis with exercise, the spine specialist will typically recommend a program of sciatica exercises that is a hybrid of:

See Lower Back Stabilization Exercises for Back Pain

The goal of this type of sciatica exercise program is to teach the lumbar spine to remain stable when bent forward. Therefore, the sciatica exercises for isthmic spondylolisthesis are a combination of both programs.

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Guided Exercises for Isthmic Spondylolisthesis

These sciatica exercises often require specific hands-on instruction from a physical therapist or other specialist because they can be ineffective if done incorrectly, and the exercises tend to be more difficult to do than they appear.

An exercise program that treats sciatica cause by isthmic spondylolisthesis typically includes a hybrid of flexion-based exercises and stabilization exercises. Watch: Sciatica Exercises for Isthmic Spondylolisthesis Video

Three exercises that are commonly prescribed for sciatic pain from isthmic spondylolisthesis include:

  • Pelvic tilt. Lying on the back with knees bent, flatten the back by tightening the lower stomach muscles and pulling the navel in and toward the sternum. Hold this position for 10 to 20 seconds, then relax the muscles. Aim to complete a set of 10 pelvic tilts to strengthen the lower stomach muscles.
  • Curl-ups. Lie on the back with knees bent, fold arms across the chest, and flatten the back to a pelvic tilt. Then curl-up, lifting the head and shoulders from the floor. Do not attempt to lift too high. To reduce the risk of hurting the neck, place the hands behind the head for support. Hold for 2 to 4 seconds, then slowly lower to starting position. As strength builds, aim to complete 2 sets of 10 curls.
  • Hook-lying march. Lie on the back with knees bent, then alternate picking one foot up off the ground for 3 to 4 seconds. This exercise can also be done while alternating raising the arms above the head (called a hook-lying march combination). Aim to march for 30 seconds and complete 2 to 3 repetitions, with 30-second breaks in between repetitions.

See Physical Therapy and Exercise for Sciatica

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The goal of the above exercises is to strengthen the lower back and abdominal muscles, which will in turn better support the spine to ease nerve root irritation and alleviate pain. Exercises for isthmic spondylolisthesis are generally only effective if the vertebra has not slipped too far forward.

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