Introduction
Spondylolisthesis is where one of the bones in your spine, called a vertebra, slips forward. It can be painful, but there are treatments that can help.
It may happen anywhere along the spine, but is most common in the lower back.
Check if you have spondylolisthesis
The main symptoms of spondylolisthesis include:
- pain in your lower back, often worse when standing or walking and relieved when sitting or bending forward
- pain spreading to your bottom or thighs
- tight hamstrings (the muscles in the back of your thighs)
- pain, numbness or tingling spreading from your lower back down 1 leg (sciatica ↗)
Spondylolisthesis does not always cause symptoms.
Spondylolisthesis is not the same as a slipped disc ↗. This is when the tissue between the bones in your spine pushes out.
See a GP if:
- you have lower back pain that does not go away after 3 to 4 weeks
- you have pain in your thighs or bottom that does not go away after 3 to 4 weeks
- you're finding it difficult to walk or stand up straight
- you're worried about the pain or you're struggling to cope
- you have pain, numbness and tingling down 1 leg for more than 3 or 4 weeks
What happens at your GP appointment
If you have symptoms of spondylolisthesis, the GP may examine your back.
They may also ask you to lie down and raise 1 leg straight up in the air. This is painful if you have tight hamstrings or sciatica caused by spondylolisthesis.
The GP may arrange an X-ray ↗ to see if a bone in your spine has slipped forward.
You may have other scans, such as an MRI scan ↗, if you have pain, numbness or weakness in your legs.
Treatments for spondylolisthesis
Treatments for spondylolisthesis depend on the symptoms you have and how severe they are.
Common treatments include:
- avoiding activities that make symptoms worse, such as bending, lifting, athletics and gymnastics
- taking anti-inflammatory painkillers such as ibuprofen ↗ or stronger painkillers on prescription
- steroid injections ↗ in your back to relieve pain, numbness and tingling in your leg
- physiotherapy to strengthen and stretch the muscles in your lower back, tummy and legs
The GP may refer you to a physiotherapist, or you can refer yourself in some areas.
Waiting times for physiotherapy on the NHS can be long. You can also get it privately.
Find a physiotherapist on the Chartered Society of Physiotherapy website ↗
The GP may refer you to a specialist for back surgery if other treatments do not work.
Types of surgery include:
- spinal fusion – the slipped bone (vertebra) is joined to the bone below with metal rods, screws and a bone graft
- lumbar decompression ↗ – a procedure to relieve pressure on the compressed spinal nerves
The operation is done under general anaesthetic ↗, which means you will not be awake.
Recovery from surgery can take several weeks, but if often improves many of the symptoms of spondylolisthesis.
Talk to your surgeon about the risks and benefits of spinal surgery.
Causes of spondylolisthesis
Spondylolisthesis can:
- happen as you get older – the bones of the spine can weaken with age
- run in families
- be caused by a tiny crack in a bone (stress fracture) – this is more common in athletes and gymnasts