21/02/2025
Some people have spondylolisthesis and never experience symptoms. Very minor (low-grade) slippage may not put enough pressure on the rest of your spine or nerves to cause any symptoms.
If you do have symptoms, they might include:
Lower back pain.
Sciatica (pain in your legs).
Back stiffness.
Difficulty walking or standing for more than a few minutes at a time.
Numbness, weakness or tingling in your feet.
You might feel pain in other areas of your back, depending on where in your spine the vertebra slips out of place. The pain might spread (radiate) into your butt (buttocks) or thighs.
What causes spondylolisthesis?
What makes a vertebra slip out of alignment depends on which type of spondylolisthesis you have. The most common causes include:
Natural aging and wear and tear on your spinal disks.
Having naturally thinner vertebrae than usual.
Sports injuries.
Growth spurts (in kids and teens).
Traumas like falls or car accidents.
What are the risk factors?
Spondylolisthesis can affect anyone, but some people have a higher risk, including:
People older than 50.
Females.
Athletes (especially people who play contact sports or have to jump or stretch a lot).
People with a biological family history of spondylolisthesis or conditions that affect their bone health.
What are the complications of spondylolisthesis?
If it’s not diagnosed and treated, spondylolisthesis can increase your risk of:
Chronic pain in your back.
Spinal arthritis.
Nerve damage.
Trouble controlling when you p*e (urinary incontinence) or p**p (bowel incontinence).
Diagnosis and Tests
How do healthcare providers diagnose spondylolisthesis?
A healthcare provider will diagnose spondylolisthesis with a physical exam and imaging tests. They’ll examine your back and spine.
Tell your provider when you first noticed pain or other symptoms, and if any activities or movements make the symptoms worse. Let your provider know what you were doing before symptoms started, especially if you know you experienced a specific injury.
Your provider will use a spinal X-ray to take pictures of your vertebrae. You might also need a CT scan (computed tomography scan) or MRI (magnetic resonance imaging) to look for damage to your disks or nerves.
Spondylolisthesis grades
Your provider will classify the spondylolisthesis with a grade to indicate how far out of position your vertebra slipped. They might use a number grade or simply define it as low or high:
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Low-grade spondylolisthesis (Grade I and Grade II): Low-grade spondylolisthesis is the most common type. Most teens with isthmic spondylolisthesis and adults with degenerative spondylolisthesis have low-grade cases.
High-grade spondylolisthesis (Grade III and Grade IV): High-grade cases are much more likely to require surgery, especially if you’re experiencing severe pain or other symptoms.
Management and Treatment
What are spondylolisthesis treatments?
Most people with spondylolisthesis can manage their symptoms with nonsurgical treatments, including:
Rest: Taking a break from sports and other intense physical activities reduces stress on your spine.
Medications: Over-the-counter (OTC) NSAIDs or acetaminophen can help reduce pain and inflammation. Don’t take over-the-counter pain relievers for more than 10 days in a row without talking to your provider. Talk to your provider before starting any at-home medications — they’ll tell you which ones are safe for you.
Corticosteroids: Corticosteroids are prescription anti-inflammatory medications. Your provider might prescribe you an oral medication that you’ll take by mouth. They might also give you a cortisone shot directly into the affected area.
Physical therapy: A physical therapist will give you exercises to strengthen the muscles around your spine, including your back muscles and your core (your abdominal muscles). This can relieve stress on your spine and help you move better.
Wearing a brace: If you have a vertebra fracture, your provider might recommend you wear a back brace to stabilize your spine. Your provider will tell you how long you’ll need to wear a brace.
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When do you need surgery for spondylolisthesis?
Not everyone needs surgery to fix spondylolisthesis. It’s possible to live with a low-grade slippage if the out-of-place vertebra doesn’t cause severe symptoms or increase your risk of complications.
