Low Back & Pelvis
Spondylolisthesis
Also called: Vertebral slippage
Forward slippage of one vertebra on another — from a pars defect (younger patients) or degenerative joint changes (typically 50+, most often L4-5). Graded by percentage slipped. Low grades are common, often stable, and respond well to strengthening-centered care.
Common signs
- Low back ache, worse with standing and extension
- A 'step' sometimes felt in the spine
- Tight hamstrings
- With degenerative slips: stenosis-type leg symptoms when walking
- Relief with sitting or bending forward
Seek help now if
- Bladder/bowel changes or saddle numbness — emergency
- Progressive neurological deficits
- Rapidly worsening slip in an adolescent
Any of these: call 911 or get to an emergency room first. Everything else can wait.
What to do first
- Standing X-rays diagnose and grade the slip; flexion-extension views assess stability
- Most Grade 1–2 slips: conservative care is first-line and usually sufficient
- Begin an anti-extension core and hip program — stability is trained, not just hoped for
If it's become chronic
- Long-term success = core endurance + hip mobility/strength + activity modification for extension-heavy loading
- Adolescents are monitored through growth; adults monitored if symptoms change
- Surgical consult for high-grade, unstable, or neurologically progressive slips
Natural healing options we use
- Chiropractic care adapted to the slip (avoiding aggressive extension at the level)
- Flexion-biased mobility and stabilization exercise
- Manual therapy for compensating musculature
- PEMF and attended e-stim for symptomatic periods
About imaging
Standing lateral X-rays (grading), flexion-extension views (stability); MRI when nerve symptoms present.
Daily self-care
- Daily core-endurance routine
- Hamstring mobility work
- Modify extension-loaded activities; hinge, don't arch
More in Low Back & Pelvis
Lumbar Sprain/StrainLumbar Disc HerniationSciatica / Lumbar RadiculopathyLumbar Facet SyndromeLumbar Degenerative Disc DiseaseLumbar Spinal StenosisSpondylolysisSacroiliac
Please read: this page is education, not a diagnosis. A proper examination is how a condition gets confirmed and a plan gets built. See our medical disclaimer.