Low Back & Pelvis

What It Is

Spondylolisthesis is a condition where one of the bones of the spine (a vertebra) slips forward compared with the vertebra below it. It can happen anywhere along the spine but is most common in the lower back (NHS, 2026). A backward slip is called retrolisthesis and is usually described as a separate condition. Spondylolisthesis can narrow the spinal canal or press on the nerve roots that leave the spine in that area.

Spondylolisthesis can cause low back pain, pain spreading to the bottom or thighs, tight hamstrings, or pain and tingling down one leg (sciatica). However, in many cases it causes no symptoms (NHS, 2026). Sometimes the person will report a previous injury to the spine during sport or a hobby.

Spondylolisthesis Anatomy

Vertebrae are the blocks of bone in your spine. They are separated by discs and linked by small facet joints. At the back of each vertebra is a narrow bridge of bone called the pars interarticularis (the pars), which connects the upper and lower facet joints (AAOS, n.d.). The pars can crack (a stress fracture), and the vertebra can then slip forwards.

Causes of Spondylolisthesis

Spondylolisthesis can happen as you get older, because the bones of the spine can weaken with age, and it can run in families (NHS, 2026). It can also be caused by a stress fracture, which is more common in young athletes and gymnasts (NHS, 2026). Sports that involve repeated over-arching (hyperextension) of the lower back, such as gymnastics, football and weightlifting, increase the risk (AAOS, n.d.). Sometimes there is no obvious reason.

A doctor will usually arrange an X-ray, which can show whether a vertebra has slipped forward and by how much. An MRI scan may be used if you have pain, numbness or weakness in your legs (NHS, 2026; AAOS, n.d.). If the slip is large, I may be able to feel a small step in your spine, but this is not a reliable way to diagnose it.

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Spondylolisthesis

Exercises to strengthen and stretch the muscles in your lower back, tummy and legs, including tight hamstrings, are part of treatment (NHS, 2026; AAOS, n.d.). I can guide you through this with hands-on work and a graded exercise programme. See the My Approach tab for how I work.

1. Reduce Extension of the Spine

Take short periods of rest from activities that make symptoms worse, such as over-arching your back, bending, lifting, athletics and gymnastics (NHS, 2026). Give the injured area time to heal and recover.

2. Anti-Inflammatory Medication

The NHS lists anti-inflammatory painkillers such as ibuprofen as a common treatment for spondylolisthesis (NHS, 2026). (This medicine information comes from the NHS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Steroid injection: an injection in the back to relieve pain, numbness and tingling in the leg (NHS, 2026).
Brace: some people may be given a back brace to limit movement in the spine and allow a recent stress fracture to heal (AAOS, n.d.).
Surgery: if other treatments do not work, an operation such as spinal fusion (joining the slipped vertebra to the one below) or lumbar decompression (relieving pressure on the nerves) may be considered (NHS, 2026).

How I can help (see the My Approach tab)

Hands-on work for tight back, buttock and hamstring muscles
Exercises to build strength and control around your lower back
Advice on activity and a gradual return to sport

Tips

Activities like weightlifting, gymnastics, football and athletics can increase the risk of this condition (AAOS, n.d.; NHS, 2026).
Most people with the condition find relief through non-surgical treatments, without needing surgery (AAOS, n.d.).
If non-surgical treatments do not help, your family doctor or nurse practitioner may refer you to a specialist to discuss surgery.
Many people with this condition have no pain, and only become aware of the problem after a routine X-ray or scan (AAOS, n.d.).

Treatment

My Approach

Spondylolisthesis usually responds to the right kind of exercise: not loosening everything, but teaching the deep muscles around your lower back to hold it steady. How I help depends on how severe it is.

If it's mild (back or buttock pain, tight hamstrings, or leg symptoms without weakness), I can treat you directly. If the slip is severe, or you have leg weakness, numbness or other nerve signs that are getting worse, or you find it hard to walk or stand up straight, please see your family doctor or nurse practitioner first; then I can support your medical team's plan. After spinal surgery, I need your surgeon's okay before any hands-on treatment.

Please bring any X-ray or scan reports and notes from your medical team to your first visit. They're an important part of planning safe treatment for you.

I assess how your back and hips move, your posture, hamstrings and trunk strength, and check the nerves to your legs (sensation, reflexes and strength).

If It's Mild

Hands-on work for the low back, buttock and hamstrings, with warm or cool applications
Gentle, low-velocity mobilisation above the slipped level, never at the slip itself and never quick thrusts
Nerve glides if your leg is irritated, and less over-arching and heavy lifting for a while
Switching on the deep stomach and back muscles, then bridges, side planks, partial squats and lunges
Hamstring stretches, a home programme, and gym work and sport built back up gradually

If It's Severe

Easing the muscles that tighten around the problem, within your team's limits
Gentle exercise your team is happy with, and scar work once healed if you had surgery
Rebuilding strength and control step by step

Buttock and hip work needs your informed consent and a written consent form. If you get numbness around your genitals or bottom, or changes in your bladder or bowels, call 911 or go to the emergency room.

What to Expect

Typical Course

Typical course: If it's mild, most people come once or twice a week at first, then weekly, then less often as you take over the home programme, with a reassessment at about 4 to 6 weeks; symptoms usually ease over about 6 to 12 weeks. If it's severe, visits fit around your medical team's plan, and after surgery recovery usually takes several months, at the pace your surgeon sets.

What I Focus On

Assessment & Nerve Screening

Back & Hamstring Release

Deep Core Control

Progressive Strength

Gradual Return to Activity

Please read

When to See a Doctor First

When to See Your Family Doctor or Nurse Practitioner

See your family doctor or nurse practitioner if you have lower back, thigh or bottom pain that does not go away after 3 to 4 weeks, you find it difficult to walk or stand up straight, you have pain, numbness or tingling down one leg for more than 3 or 4 weeks, or you also have a high temperature, night sweats or weight loss without trying (NHS, 2026).

Sources

References

NHS (2026) Spondylolisthesis. Available at: https://www.nhs.uk/conditions/spondylolisthesis/ (Accessed: 7 October 2026).
American Academy of Orthopaedic Surgeons (n.d.) Spondylolysis and spondylolisthesis. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/spondylolysis-and-spondylolisthesis/ (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooSpondylolisthesis

What It Is

Spondylolisthesis Anatomy

Causes of Spondylolisthesis

Self-Care & Treatment

How to Treat Spondylolisthesis

1. Reduce Extension of the Spine

2. Anti-Inflammatory Medication

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

If It's Mild

If It's Severe

Typical Course

When to See a Doctor First

When to See Your Family Doctor or Nurse Practitioner

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooSpondylolisthesis

What It Is

Spondylolisthesis Anatomy

Causes of Spondylolisthesis

Self-Care & Treatment

How to Treat Spondylolisthesis

1. Reduce Extension of the Spine

2. Anti-Inflammatory Medication

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

If It's Mild

If It's Severe

Typical Course

When to See a Doctor First

When to See Your Family Doctor or Nurse Practitioner

References

Related Conditions

Acute Back Pain

Cervical Disc Herniation

Cervical Facet Joint Sprain

Cervical Spondylosis

Book a session