Spondylolisthesis

Spondylolisthesis is a spinal condition where one vertebra slips forward over the one beneath it. This slippage most often occurs in the lower back (lumbar spine) and can range from mild to severe. The severity is graded based on the degree of vertebral shift.

 

Causes:

Spondylolisthesis can develop due to several reasons. In younger individuals, it may be caused by a congenital defect or stress fractures from repetitive strain (common in athletes such as gymnasts, weightlifters, and football players). In adults, it is frequently linked with age-related degeneration of the spinal structures, including the intervertebral discs and facet joints. Trauma, high-impact injuries, or certain diseases that weaken the bone (like osteoporosis) can also contribute.

 

Symptoms:

Patients often present with lower back pain that may radiate into the buttocks, thighs, or even down the legs if nerves are compressed. Other common symptoms include stiffness, tight hamstrings, leg weakness, and, in severe cases, difficulty walking or standing for extended periods. Some individuals, however, may have minimal symptoms despite noticeable slippage.

 

Treatment:

The treatment approach depends on the degree of slippage and the severity of symptoms. Mild cases may be managed conservatively with rest, pain management, bracing, and guided physical therapy. Severe cases, especially those with nerve involvement or progressive slippage, may require surgical intervention such as spinal fusion.

 

Role of Physiotherapy:

Physiotherapy plays a crucial role in both prevention and management. Key goals include pain reduction, improving spinal stability, and restoring function. A physiotherapist designs tailored exercise programs focusing on:

• Improving stability & mobility.

• Core strengthening to stabilise the spine and reduce strain.

• Hamstring and hip flexibility exercises to ease tension and improve mobility.

• Posture correction and ergonomic training to prevent the condition from worsening.

• Gradual functional training to help patients safely return to daily and sporting activities.

In addition, physiotherapists guide patients on lifestyle modifications, activity pacing, and safe movement strategies to minimise recurrence or progression.

With consistent therapy and proper management, many patients with spondylolisthesis can lead active, pain-free lives without needing surgery.