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Condition

Spondylolisthesis

Spondylolisthesis is when one vertebra slips forward over the one below it. The result is often a deep low back pain, sometimes with leg symptoms, that worsens with activity.

Overview

The slip can come from age-related arthritis, a stress fracture, or a congenital pattern. It changes how the spine handles load and can put pressure on nearby nerves.

Most patients improve with a stepped plan of targeted injections, activity modification, and core-focused rehab. Surgery is reserved for progressive slips or severe nerve symptoms.

Symptoms & causes

The pattern depends on how much slip is present and whether nerves are being affected.

Deep low back pain that worsens with standing, walking, or backbending
Leg pain or heaviness if a nerve root is being compressed
Stiffness and tight hamstrings
Relief when sitting or leaning forward

When to see a doctor

Seek care if…

Seek urgent care for new bladder or bowel changes, saddle numbness, or progressive leg weakness. These need same-day evaluation.

Frequently asked questions

Will my spondylolisthesis get worse?

In adults, most slips are stable and do not progress significantly. Routine monitoring and a good strength-based rehab plan keep things steady for most patients.

Can I exercise with spondylolisthesis?

Yes, and you probably should. Core and glute strengthening, along with posture work, often reduce pain and improve long-term outcomes. We coordinate with physical therapy to pick the right exercises.

How do I know if I need surgery?

Most patients do not. Surgery becomes a consideration for progressive slips, severe neurologic symptoms, or pain that has not responded to a full course of non-surgical care.