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Spinal Instability

Spinal Instability


The definition of spinal instability is still somewhat poorly understood. But generally speaking, spinal instability occurs when a spine injury or degenerative changes lead to structural changes, abnormal movement and abnormal load transfer within the spine. Instability can develop if any one of the 3 subsystems that make up the spine suffer damage.

  • The passive subsystem includes the vertebrae, ligaments, intervertebral discs and facet joints responsible for providing stabilization and support.
  • The active subsystem includes the muscles and tendons responsible for providing movement within the spine.
  • The neural subsystem includes the nerves and central nervous system responsible for controlling the amount of motion within the spine.

When one or more subsystems suffer an injury or damage, it can lead to excessive motion in the spine. Additionally, other structures in the spine must overcompensate and bear an abnormal load. Instability can cause pain, symptoms, and an inability of the spine to maintain normal structure and movement.


There are multiple conditions that may contribute to spinal instability. Below are some of the most common:

  • Age-related degeneration of the intervertebral discs or facet joints
  • Spondylolisthesis 
  • A spinal deformity like scoliosis
  • A back injury like a fracture
  • Congenital defects
  • Spinal tumors 


Displacement and abnormal movement of spinal structures can cause low back pain, stiffness, muscle spasms and a feeling like the back is “giving way” during movement. The pain might worsen when performing activities that place more pressure on the spine, like lifting heavy objects, bending or twisting. Additionally, displacement of spinal discs and vertebrae can cause irritation and compression of nearby nerve roots or the spinal cord. 

Sciatica is a common set of symptoms that develops when the lumbar spine nerves are compressed. Sciatica is characterized by one-sided sharp, burning or electric pain that starts in the low back and runs down the buttock, back of the thigh, calf and foot. It can also cause numbness, tingling and weakness along the same pathway. Sciatic pain is worsened by standing or sitting for long periods, or triggered by coughing, sneezing or laughing.


Mild cases of spinal instability are treated with conservative measures. The goal of treatment is to reduce pain and strengthen the muscles that support the spine. Your doctor may prescribe the following:

  • Activity modifications. Try to avoid activities that trigger pain or cause painful muscle spasms. 
  • Medications. Over-the-counter painkillers (acetaminophen) and anti-inflammatories (ibuprofen, aspirin, naproxen) can help relieve mild to moderate pain. If you’re experiencing significant pain and muscle spasms, your doctor may prescribe stronger pain medications or muscle relaxants. 
  • Physical therapy. Physical therapy plays an important role in treating spinal instability. Therapy focuses on strengthening the back, core and leg muscles that support and stabilize the spine. Your therapist will also guide you through low-impact activities and strengthening exercises to keep doing at home, to remain active and maintain strength and mobility. 
  • Injections. A corticosteroid injection directly into the spine can help reduce inflammation and irritation around compressed nerve roots. The effects of cortisone shots are temporary, and may provide up to a few months or a year of pain relief.

If conservative treatments fail to resolve pain and symptoms, surgery is the next step.


Mild to moderate spinal instability usually requires surgery, especially if nerve compression and nerve damage is involved. One surgical option is to remove the degenerated disc and replace it with an artificial disc. Another surgical option is to remove the degenerated disc and fuse the adjacent vertebrae to limit movement and instability at the vertebral level.


At Integrity Spine and Orthopedics, we specialize in identifying, diagnosing and treating a wide range of acute and chronic back, spine and joint conditions. Our board-certified orthopedic surgeons specialize in performing minimally invasive spine surgeries to reduce pain and improve mobility for patients diagnosed with spinal arthritis, degenerative disc disease, bulging or herniated discs, a pinched nerve, spinal stenosis and more. 

Some of the primary benefits of minimally invasive surgery include:

  • Smaller incisions
  • Fewer complications and bloss loss during surgery
  • Less damage to surrounding muscle and soft tissues
  • Lower risk of infection
  • Less post-op pain and less reliance on strong pain medications during recovery
  • Faster recovery and rehabilitation
  • Better cosmetic results with minimal scarring 

If you’re experiencing back or joint pain, weakness, or a loss of mobility, reach out to us today to schedule a consultation with our team. We provide compassionate and comprehensive care to help you find relief from pain and get back to doing the activities you love. 

Call us at 904-456-0017 or contact us online to request an appointment.