Can the Onset of Degenerative Spine Conditions Be Acute?

Question: I have lumbar spinal stenosis and spondylolisthesis that has caused almost constant back pain and occasional muscle spasms. These symptoms all began last spring when I lifted a child just a foot off the ground. I immediately felt a "snap" sensation in my lower back. This became progressively more severe until I couldn't walk or stand up straight this past summer. If these are degenerative spine diseases, how can the onset be so acute? I never had back problems before.
— Port Arthur, TX

Woman trying to stand up with severe low back painAnswer: For many people who have lumbar spinal stenosis and spondylolisthesis, the cause is degeneration. Symptoms of degeneration and pressure on the nerves in the low back can occur very slowly—sometimes over years and decades.

There are typically no symptoms of degeneration in the early stages, so many people don't even know they have a spine condition. Also, you don't need to have a history of back problems to be diagnosed with a degenerative spine condition, such as spinal stenosis or spondylolisthesis.

Degeneration is actually part of the normal wear and tear process of our spine. To help you visualize the degeneration process, let's compare a new rubber band to an old dried out rubber band.

A new rubber band is resilient: It will withstand a lot of stretching and still return to its original shape. Even if you pull it hard, it will still spring back.

Now, think of an old dried out rubber band. If that old rubber band is gently stretched and then released, it will maintain its shape.

However, if it is suddenly pulled forcefully, the rubber band will crack or break, and it won't be able to regain its normal shape the way a new rubber band would.

Thinking of your spine as an old rubber band that has been developing tiny cracks over the years can help you visualize what happened to your back. The minor trauma that occurred when lifting the child was the final straw that weakened your spine, leaving it unable to return to its previous healthy state.

With degeneration, the structures of the low back, including intervertebral discs and facet joints, can become weak and more prone to injury. Although the degeneration of your spine could have been slowly occurring for years, it's common to "suddenly" develop symptoms after a relatively mild trauma, such as lifting a child off the ground.

The snapping sensation you felt in your low back was probably due to some additional injury or trauma and your back was less able to tolerate this trauma because of the degeneration that was already occurring. The degeneration that has been steadily developing in your low back weakened your spine—even before the onset of your symptoms.

Talk to your doctor about your treatment options for spinal stenosis and spondylolisthesis. He or she can recommend treatments that can help you manage your back pain and other symptoms so you can increase your normal activities.