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How Does Obesity Affect Spondylolysis or Spondylolisthesis?

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Updated May 24, 2010

Question: How Does Obesity Affect Spondylolysis or Spondylolisthesis?
Spondylolysis and spondylolisthesis are related conditions. Spondylolysis is a stress fracture in a joint on the back of the vertebral column known as the pars interarticularis. Spondylosis can lead to spondylolisthesis, which is a forward slipping of the whole vertebra.
Answer: Additional weight, especially in the belly area, puts pressure on the stress fracture, weakening the pars even more. When it increases the degree of lordosis, or curvature, in your low back, the body of the vertebra may move forward independently of the structures in the back, dragging the nerve root with it. This is all but certain to cause pain.

Research shows that although spondylolysis and spondylolisthesis are usually attributed to adolescent athletes who hyperextend their spines again and again, these conditions are also associated with high body mass index (BMI) and obesity in adults. Along with other factors (aging, degree of forward pelvic tilt and degree of lumbar lordosis) obesity has been found to increase the risk and possibly the prevalence in the non-athletic adult population. Spondylolysis also runs in families, suggesting a heritable predisposition as well.

Dr. Kevin Cichocki, clinical chiropractor and founder of Palladian Health, advises that an overweight condition may further destabilize the spinal column. "With weight gain," he says, "there is a propensity for spondylolysis and spondylolisthesis to worsen." He adds, "Keeping yourself at a healthy weight and having strong abdominal muscles can help keep the spine stable."

Symptoms of spondylolysis and spondylolisthesis include lower back pain that is worsened with activity, especially when you hyperextend your spine. Stiffness, muscle tightness, particularly in the hamstrings (muscles on the back of your thigh), pain in the thighs and buttocks and/or tenderness in the area of the injury may also be present.

Sources:

Anandacoomarasamy A, Caterson I, Sambrook P, Fransen M, March L. The impact of obesity on the musculoskeletal system. Int J Obes (Lond). 2008 Feb
Lementowski PW, Zelicof SB. Obesity and osteoarthritis. Am. J. Orthop. March 2008.

de Sá Pinto AL, de Barros Holanda PM, Radu AS, Villares SM, Lima FR.Musculoskeletal findings in obese children.

Peytremann-Bridevaux I, Santos-Eggimann B. Health correlates of overweight and obesity in adults aged 50 years and over: results from the Survey of Health, Ageing and Retirement in Europe (SHARE). Obesity and health in Europeans aged > or = 50 years. Swiss Med Wkly. May 2008.

Sonne-Holm S, Jacobsen S, Rovsing HC, Monrad H, Gebuhr P. Lumbar spondylolysis: a life long dynamic condition? A cross sectional survey of 4.151 adults. Eur Spine J. 2007 Jun;
Jacobsen S, Sonne-Holm S, Rovsing H, Monrad H, Gebuhr P. Degenerative lumbar spondylolisthesis: an epidemiological perspective: the Copenhagen Osteoarthritis Study. Spine. 2007

Telephone interview. Kevin Cichocki, clinical chiropractor, founder of Palladian Health and Chairman of the Board of the Erie County Medical Center.
Telephone interview. Dr. Neil Vance, DC. Gastonia, NC. Oct 2008

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