What is Spondylolisthesis / Spondylolysis? (Part 1)

what is spondylolisthesis

What will help you to get relief from your spondylolisthesis or spondylolysis is to fully understand your condition. You need to know what exactly is going on beneath your skin to help relieve pain.

Having knowledge about your spondylolisthesis or spondylolysis will not only answer many of your questions, but it will help you to understand how your body works. Once you begin to learn how the body works, you can start feeling better with the right spondylolisthesis exercises and stretches.

So let’s begin a quick spondy lesson!

Spondy is a slang term used to describe the very confusing doctor terminology for the conditions Spondylolysis and Spondylolisthesis. Spondylos is a Greek term simply meaning spine or vertebrae, and lysis, which means a break or loosening.  You combine the two: a break or loosening of the spine. One of the most common break or stress fractures occurs in the low back or lumbar spine just above the sacral spine.

Anatomy and Terminology (Don’t worry! We kept it simple.)

The boring long anatomy words are confusing and easily forgotten (that is why we prefer the term “spondy.”) The following terms are often misunderstood, not talked about, or easily forgotten. However, they are important to know for your recovery. Please take a second to read about them. We tried to make them easy to understand!

1. Pars Interarticularis

The bony projection on the left and right sides of each vertebral segment. Once too much stress is applied, these bony projections suffer a break. Once a break occurs at this segment, it is called an isthmic spondylolysis.spondylolysis

Many people don’t realize what the pars interarticularis is, but it plays a very important role in those who suffer from isthmic spondys.

Sometimes the fracture of the pars can occur on both sides of the vertebrae (bi-lateral spondy), when this happens slippage or displacement of the vertebrae can occur (spondylolisthesis).

(It is tough too see, but the break is located in the 3rd vertebra down from the top. Start up top and count down to the 3rd vertebra to locate the break.)

2. Lumbar Spine

The portion of the spine located about the same height as the belly button and works down towards the buttocks. There are 5 total segments of the lumbar spine. You might hear your doctor label the lumbar segments as L1, L2, L3, L4 and L5. The “L” before the number refers to lumbar.

3. Sacral Spine

Located directly below the lumbar portion of the spine. The sacral spine also has segments. The 5th lumbar vertebra and 1st sacral segment meet in the low back. This is a common location of the fractures amongst spondy patients. Many suffer their spondys at L5/S1 or 5th lumbar/1st sacral vertebra.

4. Spondylolisthesis Grades

A spondylolisthesis is graded according to the amount of slippage or displacement present. A spondylolisthesis could be graded from a 1 (least amount of displacement) to a 4 (most amount of slippage). This would be refered to having a spondylolisthesis grade 1 etc.

Understanding your condition in combination with the right spondylolisthesis therapy program can lead to better movement and decreased pain. Click HERE for part 2 of  “What Is Spondylolisthesis / Spondylolysis” where we will discuss the difference between a spondylolisthesis and spondylolysis.

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Leave A Reply (33 comments so far)


  1. Amanda
    5 years ago

    Hi Justin, I’ve just been diagnosed with spondylolisthesis grade 1 at L5/S1 but with no sign of spondylolysis. Is it possible to have the former without the latter?


    • Spondy
      5 years ago

      Hello Amanda,

      For many a spondylolysis (fracture of the vertabrae with no slip) occurs first and then a spondylolisthesis (fracture of the vertabrae with a slip) can occur over time if the spondylolysis goes without getting diagnosed. Sometimes those with spondylolysis have little to no pain and the symptoms go unnoticed or ignored. Over time the stress that is applied to this area can lead to the slip of the vertabrae which is then labeled as a spondylolisthesis.

      Since I am not a doctor and cannot examine you personally, I do not know your exact situation and my answer is more of an example than anything. Most who have a spondylolisthesis probably had a spondylolysis at sometime until it progressed or slipped. But there are also those who may have had a tramatic accident and the damage involved slippage right away. I hope this answer did not confuse you and I am sorry I could not provide you with an exact answer, but the answer to your question is more complex than a simple yes or no (great question!).

      Hopefully my answer helped some!
      Best of luck and thanks for the question!


  2. victoria witalis
    3 years ago

    Hi I am a massage therapist who works 6 days a wk. I am in my 50s and just found out I have
    spondylolysis grad 2. I have found that having large breasts has inflamed my condition due to the weight DDD! Will a breast reduction help with pain? Ty


    • SpondyInfo
      3 years ago

      Thanks for the question! While it’s easy to think breast reduction will immediately reduce strain on your upper back, it may not impact your low back pain. It is best to consult with a physician or rehab professional (or get multiple opinions) because of the multiple issues you mention.

      There are some important questions that need to be answered in regards to your spondy – they include: what is going on with the spondy? Stable or unstable? Degenerative or isthmic? Knowing these answers will help to guide rehab corrections and possible surgical procedures (including whether breast reduction is going to have an impact).

      Also, please keep in mind that your body has adapted to the way you move — whether that movement is great, so-so, or poor. The health of your soft tissues and bones are related to how you move. And your symptoms may be directly related to how you move. Improving the way your body moves and controls itself (NOT getting stronger, but restoring better quality movement and doing more of it) is the best long-term way to manage symptoms in my experience. You and your surgeon will have to decide if surgery (breast reduction or spine surgery) is appropriate, but you will likely need to evaluate your movement patterns and make the necessary corrections to get the relief you want day in and day out.


  3. Barb
    3 years ago

    Hi Justin,
    I was diagnosed with a grade 1 spondy this past summer. Before that I was struggling with intense pain and mobility restrictions for about 18 months. I travelled from practitioner to practitioner and got very little help or information.
    I have learned more from the little bit I’ve read from you than years of doctor’s visits.
    I am all about information and I think you are going to be my “new best friend”!!!\
    Thank you so much 🙂
    Barb


    • SpondyInfo
      3 years ago

      Hi Barb and welcome to the site! Thanks for the kind words and I hope our information can not only help you learn more, but help you move and feel better as well. I encourage you to take advantage of our information and to ask questions and interact with comments along the way. Thanks for finding us!


  4. Dianne
    2 years ago

    I had a two level fusion at L5-L3 as it was grade 2 and three so could walk for only short distances and had very disturbed nights, back spasms so often that would wake me all through the night. I have unstable spondylolisthesis and also scoliosis. This was 2.5 years ago. I am much improved, with my own exercises, strengthening core incl. in my spa each morning. I can now walk 4.8 km but still have some issues with standing for a time in the kitchen etc. I still also . have back spasms when lying on my back, even from just startling myself i.e. dropping my book mark when reading in bed as I have to read with my arms stretched upwards! I also have a little PTSD which can be triggered when walking outside of the house. Mostly shiny walking surfaces as my system perceives this as a slipping surface. I have worked with a NLP practitioner, my chiropractor is great and I also try to desensitize myself by walking through gravel on a slope etc, this is working as I can now walk with my head upwards and looking from side to side whereas initially I was on my walking stick and could only look downwards incase I tripped on something. This was all after my operation. Any pain I had from my operation was really easy to deal with after putting up with the beforehand and very painful back spasms from before, and for about 18 months. I had pirriformus syndrome which I had to find out about myself and with the exercises I found on line this is largely sorted but I still have a few back spasms when lying flat. I sleep on my sides, now without any pillow support but I have my legs straight and bend my knees behind me so my psoas muscles are not scrunched up. I also slept somewhat with a small handtowel rolled at my bra strap level and the micro shifts in my scoliosis mean I now stand taller and straighter so I don’t feel so out of balance, and I think this has helped with my PTSD too. I am waiting on new glasses, this time bifocal instead of progressive as I also feel that my sometimes stilted way of walking makes my eyes move into a zone on my progressive glasses that make my vision a little blurred. So many things!! I have also found that with back problems sleeping on a doubled over piece of satin allows for easier turning over in bed. But be careful not to slip out of bed!!! I found no medication helped with back spasms and the narcotic type drugs were used just after surgery. I often don’t even take paracetamol daily but find if I take two at night this gives me a more settled night. Oh, if I wake, even half wake, I will often rock myself a little when lying on my side and this helps easy the muscles from tightening up and they don’t spasm. Also doing shoulder stands, or bridging helps stretch the back too. This makes for a very disturbed night but I only need to do this now on nights when my back is really getting to me!! Some of my findings may help others, but I would like some help with back spasms please!!!


    • SpondyInfo
      2 years ago

      Hi Diane. Thanks for sharing your story. I encourage you to look around the site and especially read the comment section to review other comments/stories. There is some fantastic information in the comment sections.

      As far as back spasms go, the first thing to do is to figure out the culprit. There are several causes for muscles spasms. Things such as dehydration, electrolyte abnormalities and more commonly – overworked or over stressed muscles. Often times muscles in the back work overtime to help the body with movements that it is performing. I explain this in more detail here:https://spondyinfo.com/how-poor-movement-can-affect-your-spondy-and-how-to-fix-it/

      Once the culprit is located then you can start to improve upon them. If it is dehydration, improving water fluid would hopefully help. If it is movement related improving upon your weaknesses would hopefully help. I explain all of this in the link provided above. I hope it helps!


  5. Shannon
    2 years ago

    After leaving the Chiropractor’s office several weeks ago in tears and bewilderment, my daughter and I have been very thankful to have found your site. My daughter is 13, a competitive dancer (ballet, gymnastics, jazz) and was recently diagnosed to have Spondy. XRays showed beyond a doubt, L4 Spondy. All we remember after hearing the doctor say that word was me asking how to spell Spondylolisthesis and my daughter saying, what do you mean I’ll never dance again? What do we do now/next…. where do we go? Do I take her to a medical doctor? Physical therapist? Chiropractor? She would like to continue, with dance/ballet, but how do we proceed in getting a complete diagnosed, and finding someone who understands what she will need to do to rehabilitate? Thank you for your wonderful help and information thus far!!!


    • SpondyInfo
      2 years ago

      Hi Shannon. Thanks for the kind words and I am sorry to hear about your daughter. I was only 16 when I was diagnosed and was a sports nut who struggled with the diagnosis. I understand her pain. I encourage you to read through the site and to read the comments below each post for more information. In our Step-By-Step Spondy Improvement Path we discuss how to go about getting a diagnosis and what to look for in therapy etc. You can learn more about that here:https://spondyinfo.com/spondy-improvement-path/

      Feel free to ask any questions you may have along the way!


  6. Rosalie
    2 years ago

    I have just been diagnosed with spondylolisthesis. I’m very confused. I have been twice to a chiropractor. He suggested I get a cortisone shot for extreme pain. I did so but my doctor suggested I don’t go back for a treatment but instead go to a pain management doctor. What should I do?


    • SpondyInfo
      2 years ago

      Hello Rosalie. I remember when I was first diagnosed. Fear, confusion and sadness were the first emotions that came to mind. These are all natural feelings of being diagnosed and the more you learn and understand your body and condition, the more these feelings will subside. I encourage you to do a couple things. 1.) Read our site. Read the blog posts, watch the videos and most importantly read the comments sections to gain an understanding of others in your situation. 2.) Remember that every doctor, chiropractor, therapist, etc will have an opinion on this condition. There is no set in stone recovery path like there is for many conditions. So everyone will have different views. I would seek out multiple opinions and discover what fits you best. Who are you comfortable with and most importantly what makes you feel better? 3.) Seek out a movement screen of somekind to help you discover what your movement is like. I discuss this in detail here:https://spondyinfo.com/how-poor-movement-can-affect-your-spondy-and-how-to-fix-it/
      This should help you get started….Best of luck and keep us informed on how it goes!


  7. sandy dwelley
    2 years ago

    Hi Justin I’ve been reading how important getting a movement screening checked them out and I don’t have one close to me , anything else I can do -I started doing your 5 stretches you do daily and it has helped the pain down the leg but now not sure if i should continue to do them until i get a movement screening please do you have any suggestions. I have to go back to the chiropractor can he tell me what level I have .


    • SpondyInfo
      2 years ago

      Hi Sandy. The good thing about movement screening is that you can have one performed and most practitioners will provide you with instant feedback along with movements, exercises and stretches you can do on your own. You can then follow up with them after a few weeks or months to gauge your levels of improvement. I would make sure to research the closest movement screening professional (SFMA is my recommendation), call them and discuss your situation. Then you can make a trip out of it. Spend a day with them or in the city they are in, get your assessment, enjoy the area and head back. Then begin working on your weaknesses! In regards to my stretches…If you find the stretches helpful and they make you feel good then, then by all means move forward. I cannot tell you to do them or not as that is up to your and your doctor. Discuss these with your chiropractor and he may be able to recommend if you should do them or not. ALWAYS listen to your body. If you experience discomfort or pain, they are probably too much at this point. You would have to discuss with your Chiropractor about the level question. Often it requires certain equipment. Best of luck!


  8. Chris squeteri
    2 years ago

    I am 32, female.. and this past summer I was diagnosed L5/S1 (this seems to be the norm). My job requires me to lift(so bending) and than i can sit or stand for a period of time… like sometimes i’m oping a camera and have to stand for 8 hours or more. My pain is pretty bad. I don’t want a cortizone shot. I just got prolozone injections. unfortunately my body wanted to menstruate .. and since i have no support group (my husband is fine but no one who knows what i am dealing with- in my age group) it s hard when I tell drs and my 1st bought with PT(horrible PT person very one minded).. my pain is about 3/4 and than way at 10 during my period. So not sure if the prolozone is working or worked yet since the other pain is too much and since i went in for 2 set of injections 2 weeks in a row. And no one seems to understand how my period effects my back.. but you are inflamed when on your period so to me it make sense yes? Anyways I want to over come this pain so i can get back to PT and be able to make my back muscle(s) strong so i can live life and get back to riding! Used to do 10-20 miles plus. But haven’t been able to do that for almost 3 years now. And when/if I can should I get a recumbent. I need to lose weight which will obviously help as well. I have a pretty good diet helping with inflammation. Anything to help. It isn’t worth the pain to eat crap. Coffee was one of the worst! Fruit carbs really help me wake up in the morning! I think Iv’e rambled on too much here. I hope it all makes sense 🙂 My main focus is to NOt take a steriod shot that yes helps the pain but also mask it and causes osteoporosis so it is a catch 22 all the way around with that shot. I haven’t been to a chrio.. is that an option that actually works for people? Not asking you or anyone to tell me to go. But is this an acutal help or hurt? I’m not looking for you to give me the end all be all.. but I am tired of being a bump on the log and would love to get up and take back my life and be active. I’ve got much more to live!
    Thanks in advance!


    • SpondyInfo
      2 years ago

      Hi Chris. Thanks for sharing your story. I encourage those reading the site to share whatever they can to not only help others who may be suffering from similar situations, but I also believe it helps to vent. So do not worry about typing to much.

      In regards to your chiropractor question I really believe there is no one answer. I personally have visited a few chiros. I have had some that have made my condition worse and others that have relieved my pain. I discuss this more here: https://spondyinfo.com/what-is-the-best-kind-of-spondylolisthesis-rehab/

      I guess the bottom line is it really depends on the chiropractor and their qualifications and background. Always make sure to discuss with a chiro their experience with spondy’s before you decide to use their services.


  9. Chris squeteri
    2 years ago

    **meant to also mention I have Degenerative Stage 1 spondylolisthesis L5/S1


  10. Dan
    2 years ago

    I have grade 1 anterolisthesis as diagnosed by MRI. Is swimming helpful in correcting this condition as part of an overall PT regimen?
    Thanks


    • SpondyInfo
      2 years ago

      Hi Dan. I wish I could give you an exact answer here, but unfortunately I am not a doctor and do not personally know your body, how it moves or your injury background. Each case of having a spondy is unique. Swimming may be just fine for one spondy patient and tough on another due to the various factors and characteristics involved.

      I discuss this concept more here: https://spondyinfo.com/10-things-that-make-your-spondy-unique/

      I encourage you to give it a read. Also discuss with your doctor and therapist (if you work with one) about your exact situation. There are many benefits of swimming. And for many spondy patients it can be a great way to improve strength, cardio, etc. without the pounding and stress on your joints and ligaments that activities like running provide. It will not correct the actual slip, but it can help to improve the above mentioned categories which in combination with a solid full body improvement plan can go along way in helping how you feel.


  11. Tom
    2 years ago

    Justin,
    I am an Ironman triathlete and diagnosed with a grade 2 Spondy at L3. Recently came across your site and am glad there is a resource for me and others – thanks for your efforts.

    I’m 60 and have been doing weight training for Ironman strength in swimming, biking and running. Can your provide any resources on exercises and/or weight training programs that will keep me able to swim, bike and run? Thanks much.


    • SpondyInfo
      2 years ago

      Hi Tom. Thanks for commenting and sharing your story. When it comes to activities such as Ironman competitions and sports that involve repetitive movements (running, cycling, etc) it is VERY important for spondy patients to have an overall solid foundation of movement. Unfortunately, most spondy patients do not. First and foremost I would recommend having your movement observed by a professional. We have always recommended a screening method called the SFMA. I discuss this more here:https://spondyinfo.com/how-poor-movement-can-affect-your-spondy-and-how-to-fix-it/

      For those who are not located near professionals and or prefer to train out of home we are finishing the final stages of an at home exercise program exclusively for those with spondy’s. We hope to release it by the end of the month. So keep an eye out for that as well.

      We have created this site for competitive and active individuals just like you Tom. So dig around, read up and make sure to read the comments. Best of luck!


  12. Barb
    1 year ago

    Have spondylolisthesis L3 on L4, L4 on L5, and L5 on S1 with instability. Issue is that the pain is not in my back nor does it radiate from my back. The pain is on the right and left side of the anterior wings of the pelvis. My research has found no connection between the spondy and the pain but my life experience points to such a connection. Have you ever run across something similar? Thanks.


    • SpondyInfo
      1 year ago

      Hi Barb. My spondy is stable and personally, the majority of my pain is located in the hips as well. I cannot ever recall having pain exactly where my spondy is located. I have experienced radiating pain though. This is just another frustrating thing about this condition. The symptoms vary so much from individual to individual. It really can be frustrating trying to learn more by searching the net. It would be hard to determine the exact reason why you are experiencing pain where you are without a thorough examination and full body screen. But often times the hip pain and discomfort is muscular in relation. I know this is the case with my pain. When I do have a setback I focus hard on the weaknesses I have in my hips and core and usually see a big improvement after a few days of doing so. Thanks for the question!


  13. Chris
    1 year ago

    Hi

    I had an MRI done in mid-September and grade 1 degenerative spondylolisthesis with severe stenosis at L4-5 was diagnosed. I was referred to a spine surgeon who said that I needed a laminectomy and spinal fusion. The rest of my spine is “pristine”. My symptoms are intermittent pain down my right (sometimes left as well) leg with tingling and sometimes numbness in my foot. I used to get pain in the buttock area but that has subsided. I manage my pain with Tylenol Arthritis strength capsules 2 pills 2 x day. I am able to exercise at the gym and walk but sitting in a car or airplane is very uncomfortable. In searching online, I read that often PT is often a non-surgical remedy. I tried this for 6 visits and the PT thought that PT wouldn’t be effective for stenosis. I am wondering whether surgery is really the only way to relieve the pressure and remove the stenosis. Thoughts?

    Chris


    • SpondyInfo
      1 year ago

      Hi Chris. Stenosis is often a tough one due to the narrowing of the spine that has occurred. There are several factors that need to be considered when considering whether or not surgery is the ONLY option. Things such as the cause of the Stenosis, your age, your injury history etc. These are all things that need to be answered by your doctor. I am not an expert in Stenosis, but from my brief studies I have really never found studies that show what is the most effective non-surgical treatment plan. My advice in situations like this that involve major decisions is to seek multiple opinions. But in the form of doctors and therapist. Just because one tells you to have surgery or therapy will not help does not mean that is the case or consensus at this time. I would recommend seeking multiple opinions from experts to gain a better understand of your exact condition and possible treatment plans. Some doctors are very pro surgery, while others will do whatever they can to avoid surgery. The more you can talk to and learn, the clearer the picture becomes. Thanks for asking and I hope this helps!


  14. Christine W Keightley
    1 year ago

    Is it possible to have a grade 1 spondylolisthesis with “severe spinal stenosis?


    • SpondyInfo
      1 year ago

      Hi Christine. Please keep in mind that I am not a doctor and my background on Stenosis is very limited. But from what I have read in the past and have come to understand the answer to your question would be yes. Stenosis is basically a narrowing of the spinal canal and can be caused by various factors, one such factor could be spondylolisthesis. I have read before that spinal stenosis often occurs with degenerative spondylolisthesis. As always, a good discussion along with proper testing protocols from your doctor will help to determine if this is the case with you. I hope that helps!


  15. Susan France
    8 months ago

    Hi all,
    I have been an avid exercise freak all my life & @ age 63 was diagnosed with L5 stress fracture leading to mild case of misalignment. After visiting Dr & chiropractor was told to strengthen my core & do some stretching but everything I did caused more pain including lifting light weights. I now walk very fast with my arms swinging, some call it race walking which I can tolerate up to a point. My biggest issue is that it hurts to sit on any kind of soft chair or recliner. I stand all day which is fine but have to lie down to watch tv at night. The biggest downer is that I’m afraid to fly because of the prolonged sitting. I can sit in straight back booth & drive with special pillow with no discomfort.
    Has anyone had success with strengthening their core? I tried for months but gave up due to pain.
    Does anyone take long plane flights?
    Thank you.


    • SpondyInfo
      8 months ago

      Hi Susan. Thanks for finding the site. I feel strengthening the core is one of the largest misconceptions of spondy’s. Yes, the core is important and it should be functioning properly, but there is so much more to it than just strengthening. One major issue is locating and correcting movement related issues that may be playing a role with the core. If you have movement issues present, and only try to strengthen the core, it may only make things worse. As far as pain when sitting goes there are several possible causes. One thing to keep in mind is that the cause of your pain from sitting may not be spondy related. The only real way to know is to have a discussion with your doctor who can observe imaging and determine the exact cause. Our site has tons of information to help you better understand these concepts, I hope you find the site helpful!

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