Merck Manual

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Peter J. Moley

, MD, Hospital for Special Surgery

Reviewed/Revised Oct 2022
Topic Resources

Spondylolisthesis is partial displacement of a bone in the lower back.

  • Injuries or a degenerative condition can cause this disorder.

  • Pain is felt in the low back and may travel down one or both legs.

  • The diagnosis is based on the results of imaging tests.

  • Treatment includes measures to relieve pain.

The spine (spinal column) consists of back bones (vertebrae) stacked one on top of another. In lumbar spondylolisthesis, a vertebrae in the lower back slips forward. This disorder usually occurs during adolescence or young adulthood (often in athletes). It is usually caused by a birth defect or an injury that causes fractures (breaks) in a part of the vertebra. If both sides of the vertebra are involved, the vertebra can then slip forward over the one below it. Spondylolisthesis can also occur in older adults, mainly as the result of degeneration of the discs between the vertebrae or osteoarthritis Osteoarthritis (OA) Osteoarthritis is a chronic disorder that causes damage to the cartilage and surrounding tissues and is characterized by pain, stiffness, and loss of function. Arthritis due to damage of joint... read more Osteoarthritis (OA) . People who develop spondylolisthesis as adults are at risk of developing lumbar spinal stenosis Lumbar Spinal Stenosis Lumbar spinal stenosis is narrowing of the spinal canal in the lower back. The narrowing squeezes (compresses) the nerves that travel through the lower back into the legs. Osteoarthritis, injuries... read more Lumbar Spinal Stenosis .

Symptoms of Spondylolisthesis

Mild to moderate spondylolisthesis may cause little or no pain, particularly in young people.

When pain occurs in adolescents, it is felt on only one side of the spine and may travel down a leg. The pain may accompany a fracture.

When pain occurs in adults, it is felt over a specific part of the spine and travels down both legs. In these cases, the pain results from a degenerative condition.

Pain is worsened by standing or leaning back. It can be accompanied by numbness, weakness, or both in the legs.

Diagnosis of Spondylolisthesis

Treatment of Spondylolisthesis

  • Measures to relieve pain and stabilize the spine

One to two days of bed rest may provide pain relief for people with spondylolisthesis. Longer bed rest weakens the core muscles Low Back Pain Low Back Pain and increases stiffness, thus worsening back pain and prolonging recovery. Sleeping in a comfortable position on a medium mattress is recommended. People who sleep on their back can place a pillow under their knees. People who sleep on their side should use a pillow to support their head in a neutral position (not tilted down toward the bed or up toward the ceiling). They should place another pillow between their knees with their hips and knees bent slightly if that relieves their back pain. People can continue to sleep on their stomach if they are comfortable doing so.

Applying cold Cold therapy (cryotherapy) Professional rehabilitation therapists treat pain and inflammation. Such treatment makes movement easier and enables people to participate more fully in rehabilitation. Techniques used include... read more (such as ice packs) or heat Heat therapy Professional rehabilitation therapists treat pain and inflammation. Such treatment makes movement easier and enables people to participate more fully in rehabilitation. Techniques used include... read more (such as a heating pad) or using over-the-counter analgesics (such as acetaminophen and nonsteroidal anti-inflammatory drugs [NSAIDs]) may help relieve the pain. Some people may be helped by drugs that reduce nerve pain, such as gabapentin, antiseizure drugs, or certain antidepressants. If pain is severe or persists, doctors may give corticosteroids taken by mouth or injected into the epidural space (between the spine and the outer layer of tissue covering the spinal cord).

Drugs Mentioned In This Article

Generic Name Select Brand Names
7T Gummy ES, Acephen, Aceta, Actamin, Adult Pain Relief, Anacin Aspirin Free, Apra, Children's Acetaminophen, Children's Pain & Fever , Comtrex Sore Throat Relief, ED-APAP, ElixSure Fever/Pain, Feverall, Genapap, Genebs, Goody's Back & Body Pain, Infantaire, Infants' Acetaminophen, LIQUID PAIN RELIEF, Little Fevers, Little Remedies Infant Fever + Pain Reliever, Mapap, Mapap Arthritis Pain, Mapap Infants, Mapap Junior, M-PAP, Nortemp, Ofirmev, Pain & Fever , Pain and Fever , PAIN RELIEF , PAIN RELIEF Extra Strength, Panadol, PediaCare Children's Fever Reducer/Pain Reliever, PediaCare Children's Smooth Metls Fever Reducer/Pain Reliever, PediaCare Infant's Fever Reducer/Pain Reliever, Pediaphen, PHARBETOL, Plus PHARMA, Q-Pap, Q-Pap Extra Strength, Silapap, Triaminic Fever Reducer and Pain Reliever, Triaminic Infant Fever Reducer and Pain Reliever, Tylenol, Tylenol 8 Hour, Tylenol 8 Hour Arthritis Pain, Tylenol 8 Hour Muscle Aches & Pain, Tylenol Arthritis Pain, Tylenol Children's, Tylenol Children's Pain+Fever, Tylenol CrushableTablet, Tylenol Extra Strength, Tylenol Infants', Tylenol Infants Pain + Fever, Tylenol Junior Strength, Tylenol Pain + Fever, Tylenol Regular Strength, Tylenol Sore Throat, XS No Aspirin, XS Pain Reliever
Active-PAC with Gabapentin, Gabarone , Gralise, Horizant, Neurontin
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