Spondylolisthesis: Causes, Symptoms & Relief | Precision Pain & Spine Institute

What Is Spondylolisthesis?

Spondylolisthesis is a spinal condition in which one vertebra slips forward over the vertebra below it. This misalignment most commonly occurs in the lower back (lumbar spine), but can affect any area of the spine. The severity can range from mild, causing few or no symptoms, to severe, leading to nerve compression, pain, and mobility challenges.
Spondylolisthesis is sometimes referred to as “vertebral slippage” or “slipped vertebra.”

Why It Happens

There are several types of spondylolisthesis, each with its own causes and risk factors:

• Isthmic spondylolisthesis: Caused by a stress fracture in a small bone (pars interarticularis) connecting the joints at the back of the spine. Common in young athletes due to repetitive extension and rotation.
• Degenerative spondylolisthesis: Develops with age due to arthritis, disc degeneration, and weakening of the joints and ligaments.
• Congenital spondylolisthesis: Present at birth due to abnormal vertebral formation.
• Traumatic spondylolisthesis: Occurs after an injury or fracture.
• Pathological spondylolisthesis: Rare, caused by diseases that weaken the bones, such as tumors or infections.
• Post-surgical spondylolisthesis: Occurs after spinal surgery.

Risk Factors

• Repetitive sports (gymnastics, football, weightlifting)
• Family history of spine problems
• Age (degenerative type more common in those over 50)
• Female sex (degenerative type is more common in women)
• Prior spinal injury or surgery
• Obesity, which increases spinal stress

Signs & Symptoms

Spondylolisthesis can range from silent to severely symptomatic. Common signs and symptoms include:

• Lower back pain: Worsened by standing, walking, or bending backward
• Pain radiating to the buttocks or legs (sciatica): If nerves are compressed
• Muscle tightness or spasms in the hamstrings
• Stiffness in the back
• Numbness or tingling in the legs or feet
• Weakness in the legs or difficulty walking
• Noticeable arch in the lower back or change in posture
• Difficulty standing up straight or walking for long periods

Red-Flag Warnings (Seek Immediate Medical Care)

• Sudden, severe leg weakness
• Loss of bladder or bowel control
• Numbness in the groin or inner thighs

Diagnosing Spondylolisthesis

At Precision Pain & Spine Institute, diagnosing spondylolisthesis begins with a comprehensive evaluation:

• History & Physical Exam: Review of your symptoms, activity, and medical history. The doctor checks spinal alignment, flexibility, and nerve function.
• Imaging:
  • X-rays: The most important first step; show vertebral slippage and grade its severity.
  • MRI: Provides detailed views of discs, nerves, and soft tissues—essential if nerve symptoms are present.
  • CT scans: Helpful in assessing bone structure and detecting stress fractures.
• Electrodiagnostic testing (EMG/NCS): If there’s numbness, tingling, or weakness, these studies help determine the extent of nerve involvement.

You’ll leave your first appointment with a clear understanding of your diagnosis and next steps.

Treatment Options

Our goal is to relieve your pain, improve function, and prevent further slippage using the least invasive, most effective therapies.

Conservative (Non-Surgical) Treatments

• Physical Therapy: Core strengthening, stretching, and stabilization exercises to support the spine, improve flexibility, and relieve pain. Therapists teach you safe movement strategies.
• Medications: NSAIDs for pain and inflammation, muscle relaxants, or neuropathic pain medications as needed.
• Activity Modification: Temporary avoidance of aggravating activities, ergonomic improvements at work or home.
• Support Bracing: Occasionally used in acute cases to limit movement and provide support during healing.

Interventional and Image-Guided Procedures

• Epidural Steroid Injections: Reduce nerve inflammation and pain for those with radiating leg symptoms.
• Facet Joint or Trigger Point Injections: Provide targeted relief for joint or muscle-related pain.
• Chiropractic Care: Gentle spinal adjustments and manual therapy may help relieve discomfort for select patients, but are not suitable for all cases.

Surgical Treatments (If Needed)

Surgery is reserved for severe cases—when conservative care fails, symptoms are disabling, or nerve function is threatened. Surgical options may include:

• Decompression (Laminectomy): Removes bone or tissue pressing on nerves.
• Spinal Fusion: Stabilizes the affected segment by joining vertebrae together, preventing further slippage.
• Minimally Invasive Techniques: Used whenever possible for faster recovery and less discomfort.

Your surgical plan will be personalized based on your age, health, goals, and lifestyle.

Living With Spondylolisthesis

With proper care, most people with spondylolisthesis can live active, fulfilling lives. Daily tips include:

• Stay active: Choose low-impact activities (walking, swimming, cycling) to maintain flexibility and strength.
• Core strengthening: Regular core and pelvic exercises reduce stress on the spine.
• Good posture: Practice proper body mechanics at work and during daily activities.
• Weight management: Maintaining a healthy weight lessens spinal strain.
• Supportive footwear: Good shoes can help with balance and alignment.
• Pain coping: Use heat, cold, and occasional over-the-counter pain relief for symptom management.
• Mental health: Chronic pain can impact mood—relaxation techniques and support can help.

Prevention Tips

• Condition your core and back muscles through regular exercise.
• Avoid repetitive heavy lifting or hyperextension movements—especially if you have a history of back pain.
• Practice proper lifting technique: Bend your knees, keep your back straight.
• Use ergonomic chairs and workstations to minimize spinal stress.
• Maintain a healthy weight and quit smoking to promote disc and joint health.
• Address injuries promptly to prevent chronic issues.

How We Can Help

At Precision Pain & Spine Institute, our collaborative team of board-certified spine specialists, orthopedic surgeons, pain management doctors, physical therapists, and chiropractors provide evidence-based, compassionate care for spondylolisthesis.
We offer advanced diagnostics, minimally invasive treatments, and personalized rehabilitation all under one roof. Same-week appointments are available, so you don’t have to wait for relief.

Frequently Asked Questions

1. Can spondylolisthesis heal on its own?

Mild cases may improve with rest, therapy, and bracing, but monitoring is essential. More severe cases may require intervention.

2. Is spondylolisthesis the same as a slipped disc?

No. Spondylolisthesis is vertebral slippage; a slipped disc refers to herniated disc material.

3. Will I always need surgery for spondylolisthesis?

Most people improve with non-surgical care. Surgery is only necessary for severe, progressive, or nerve-threatening cases.

4. Can I exercise with spondylolisthesis?

Yes, but stick to low-impact activities and avoid movements that worsen pain. Your physical therapist can provide a safe program.

5. Is spondylolisthesis a lifelong condition?

The underlying slippage does not always go away, but symptoms can be managed and function restored with proper care.