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  • Soccerplayer17
    Post count: 1

    Hi Dr. Corenman,

    I play competitive soccer, which ended up being the cause of my lower back pain for the past 6 months. It started gradually in my lower back on the right side, slightly to the right of my sacrum. I ignored it until it got worse, which evidently was foolish. It hurt on the right side, and then would switch to the left side of my sacrum. My physiotherapists naturally thought I had Sacroiliac Joint pain. However, my pain has changed over time to the point where the right side of my spine itself is sore for the lowest 3 vertebrae above my sacrum. It hurts most as I am bending forward and coming back up. When I bend backwards though, I feel a loud pop/clicking noise that causes no pain, but concerns me. Both an X-ray and MRI show spondylolisthesis. My back specialist tells me that it is extremely unusual for someone with spondylolisthesis to have pain just bending forward, as people usually have pain bending backward. He suggests an epideral injection since it hasn’t improved for so long, but I am doubtful this will help the problem. My questions are:

    1) Given the symptoms, how likely is it that my Spondylolisthesis is the cause of my pain? Could it be something else?

    2) Do people with Spondylolisthesis ever have pain bending forward instead of backwards?

    3) What is the clicking I feel when I bend backwards?

    Thank you very much, I would greatly appreciate it if you could shed some light on my mysterious and frusterating injury.

    Donald Corenman, MD, DC
    Post count: 8455

    There are many disorders that can cause lower back pain which include degenerative disc disease, facet disorders, stenosis, nerve root compression among others. One of the most common pain generators is an isthmic spondylolisthesis. The pain can be generated from the fractured pars (see website for description), the degenerative disc, compression of the exiting root or the instability.

    In your case most likely, the pain is generated from the degenerative disc or instability of this slipped level. Forward flexion loads the disc which generates the pain. The backwards bend that produces the popping noise is most likely generated by the ends of the pars fractures coming in contact with each other.

    An epidural might be temporarily helpful but probably will not give long term relief.

    Dr. Corenman

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