In spine shift, the body is actively trying to avoid irritation or compression of a spinal nerve root through spasming of a muscle. This may occur consciously or as an unconscious reflex. Spine shift may occur to either side, or to both (alternating) sides. Essentially, the upper part of the trunk is rotated to the right or left (or both sides) in comparison to the lower part of the trunk. Lateral spine shift may be caused by acute pain in the low back, disc protrusion or disc herniation. Spine shift can be detected visually by a person who is trained to assess this condition. When the condition is severe, the person may lean to either side, which may be obvious even to the untrained eye. When the condition is not as serious, the spine may be shifted when viewed from behind (i.e. the bones of the spine will look and feel crooked).
Spine shift can be corrected using manual correction (hands on manipulation), traction and by teaching the patient how to correct and maintain proper alignment.
Spondylothesis is a form of spine shift in which one or the vertebra slips forward (anterolisthesis) or backwards (retrolisthesis) over the next vertebra. This condition can cause spinal deformity, as well as spinal stenosis (narrowing of the spinal canal). Spondylothesis may also lead to compression of nerve roots (foraminal stenosis). Spondylothesis is most common in the lower back (lumbar spine), but can also occur in the neck (cervical spine) or in the mid-back (thoracic spine). Symptoms of lumbar (low back) spondylothesis include low back pain, tightness of the hamstrings and decreased range of motion in the lower back. Pain in the buttocks, thighs and legs may worsen with standing. Numbness or weakness may also occur if a nerve becomes compressed. Diagnosis can be made with x-rays. If nerve compression is suspected, a CT scan or MRI may be ordered. Treatment of spondylothesis is usually conservative at first (rest, avoiding certain activities, physical therapy, anti-inflammatories, cortisone injections); however, surgery may be necessary in some cases.
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