Causes of Spinal Instability

Many conditions can cause or contribute to spinal instability, including:

• Spondylolisthesis. With this condition, a part of the disk, a narrow bridge of bone called the pars interarticularis, breaks. This causes the vertebra to move forward onto the vertebra directly below it. Slipping vertebrae can irritate nerves and joints, squeeze disks, and weaken the spine’s integrity. It can also worsen stenosis, a narrowing of the small openings naturally present between each vertebra. Spondylolisthesis can occur in people of all ages, including young athletes who routinely overstretch the lower spine when participating in sports such as gymnastics, football, and weightlifting.
• Degenerative disks. With normal aging, the disks in the spine can dry out and deteriorate, causing the vertebrae to move closer together and become irritated.
• Osteoarthritis. With this condition, the disks break down over time. Sometimes bone spurs can form. These growths can irritate nerves and inflame tissues and facets, the joints in your spine between two vertebrae.
• Fracture. A hairline break in a disk can allow vertebrae to slip out of place, causing the spine to become unstable.
• Aging. As we get older, it’s normal for spinal joints to loosen, sometimes causing spinal instability.

Symptoms of Spinal Instability

If your spine becomes unstable, the abnormal movement can cause:

• Pain in your lower back
• Pain that shoots down the back of your leg
• Painful muscle spasms
• Back stiffness
• Tight hamstrings, which are the muscles at the back of the thigh
• Tingling, numbness, or weakness in one or both legs

After determining the cause of your spinal instability, your doctor will prescribe a treatment plan. Your treatment plan will depend on the cause of your spinal instability and its severity.

Your doctor may want you to work with a physical therapist, an expert in safe movement and exercise. Using these techniques as directed can often improve your symptoms and strengthen the muscles of your spine.

In severe cases, surgery may be recommended. One common surgery for spinal instability is spinal fusion. Spinal fusion surgery can relieve pain by preventing one or more of the damaged vertebrae in your back from moving. The procedure can be performed minimally invasively, in which smaller incisions are used that can result in faster recovery. During the surgery, two or more vertebrae of your spine are joined (“fused”) together permanently with a bone graft. Spinal fusion surgery can involve hardware, such as plates, screws, and cages to stabilize the spinal joints.

After surgery, you may need to temporarily wear a brace. Your recovery plan after surgery may also include working with a physical therapist to help you get safely back to work and your other daily activities.