What is Spondylolisthesis, and What Can You Do About It?

Types of Spondylolisthesis

Spondylolisthesis is a condition in which a vertebra will slip out of position relative to the one directly below it. This is not to be confused with a slipped (or herniated) disc, in which there is a bulging of the intervertebral discs (the soft discs between your vertebrae that act like shock absorbers). The two conditions can coexist, but don’t always occur together. Both can cause back pain which radiates down to the legs, but many patients with Spondylolisthesis can be largely free from symptoms. In some cases it’s not even diagnosed until imaging for an unrelated injury or condition reveals the slippage. Contrast with a slipped disc where the pain tends to be fairly constant, even at rest. 

How does Spondylolisthesis happen?

Spondylolisthesis can stem from a variety of causes, including:

• Stress from growth spurts (in children)

• Wear and tear from aging

• Sports injuries (some sports, like football or weightlifting which put stress on the lower back can be more prone to causing Spondylolisthesis)

There are also some genetic risk factors, Spondylolisthesis can be more common in people whose family history includes other bone disorders. People over 50 years old and women also have a somewhat higher risk of Spondylolisthesis than others. 

How is Spondylolisthesis treated?

Some experts maintain that very mild/asymptomatic cases require no treatment, and even in more serious cases there isn’t necessarily urgency to resort to interventions like surgery. If surgical intervention is required, spinal fusion to restore stability between the affected vertebrae is a common treatment. 

For more conservative treatment, physical therapy is an option. Your PT can work with you to do core strengthening exercises to improve spinal stability, and other strengthening/stretching to help increase the mobility of your lumbar spine. Hamstring stretches can also help release tension on your lower back, improving symptoms. For pain management, your PT may employ massage, heat/cold therapy, or light electrical stimulation with a TENS unit.

Your PT will also help you improve your body mechanics and advise on lifestyle changes so you can return to your normal activities and avoid placing too much strain on your spine. Overall, Spondylolisthesis is a condition with a good outlook that can typically be managed very successfully.