Why Does Spondylolisthesis Therapy Often Fail?

Spondylolisthesis Fail

A majority of the individuals I have worked with who suffer from a spondylolisthesis or spondylolysis have been through at least one failed spondylolisthesis therapy experience (for the record I am a strength and conditioning coach not a therapist).

Many have been through several different therapy clinics that failed to deliver long term results (I am in this boat as well, I went through 3 different failed spondylolisthesis therapy experiences in the past).

It could have been a few weeks of spondylolisthesis exercises and stretches that didn’t work or perhaps they felt better briefly, but  the pain returned a few weeks after therapy.

Sadly, most of these people want to give up on therapy and look for other routes such as surgery, braces, pills, etc. as methods of treatment to relieve the pain associated with their spondy.

I try to explain to those that have had failed therapy the reasons the treatment might not have worked and how they should not give up on hope just yet. There is a reason doctors often prescribe therapy for individuals with grade 1 or 2 spondy’s. The reason is because therapy can work. The battle is finding therapy that is right for YOU.

Failed treatment can occur for several reasons.  The following are a few of the most common reasons.

The point of this article is to open up your mind and provide you with information that will help you seek additional forms of therapy and not close the door or give up on therapy after one bad experience.

1. Remember….not all therapy is the same.

Many people think that all therapy is the same.  This could not be further from the truth.

Not all clinics operate with the same theories, principles or practices. There is no rule that you have to take the same path to making people feel better.

Some clinics do it one way and some do it another.  Some clinics may use machines and some may use bodyweight to perform exercises.  Some may believe in stretching and some may say it’s useless.

The clinics that keep up to date with studies and techniques and get their clients results succeed.  The ones that do not will eventually fail.

Just like you would’t give up on eating out at restaurants after one bad experience, you shouldn’t give up on your spondylolisthesis therapy after one failed visit.

2. There is no exact method for treating spondylolisthesis or spondylolysis.

Unfortunately when it comes to treating a spondylolisthesis or spondylolysis there is no exact method. You could go to 5 different clinics and receive 5 different programs designed to make you feel better. The traditional method of “strengthening the core and stretching the hamstrings” does not work for everyone.

spondylolisthesis and spondylolysis stretch

Simple hamstring stretches are NOT the answer to fixing your spondylolisthesis.

Full body movement screens have shown to be very helpful to help determine areas of weakness and expose asymmetries. The results from these screens can help the coach or therapist approach the individual with a program designed specifically for THEM.

It is not fair to place everyone who has a spondylolisthesis or spondylolysis in a certain pool.  Discuss with your therapist the approach they are taking and ask them if they have helped others who have had spondy’s with this same approach.  Open conversation with you therapist is a big key to a successful rehab.

3. Poor attention to detail or lack of coaching.

I know from experience that many clinics are being forced to assign multiple patients to therapists and coaches at a time.  The cost of hiring employees, desk managers, equipment, insurance, etc. is only going up.

Health care plans are changing and it is becoming harder for clinics to make money like they used to.  To compensate for these changes clinics are assigning multiple patients per therapist.  The result is lack of coaching, poor attention to detail, and poor results.

The therapists are scrambling to work with each customer and often times minor details and educating the client is left out.

The details that are neglected can add up over time and the poor movement or deficiencies that people walk in the door with go untouched. The stretching, ice and ultrasound may help the person feel better momentarily, but weeks later the poor movement builds up and pain returns.

You should be able to talk to your therapist and ask them questions.  They should also be able to help you through an exercise without having to run around for minutes at a time.  If an exercise is causing you pain or you doubt you are doing it correctly, ask your therapist for help.  No let the small things slide.

All of these observations are from my experience of failed therapy and hearing others discuss their stories as well.

Not all clinics are guilty of the previously mentioned reasons.  Some clinics are PHENOMINAL and do a great job.  They help clients by educating them, relating to them and most importantly they make them feel better!

The hard part for us is to find clinics that do this.

Let us know in the comment section below if you have had a great experience at a clinic. Your recommendation might help a fellow spondylolisthesis sufferer located near bye.

If you have had a bad experience you now know what to look for.  Look around and find another clinic before you throw in the towel on therapy.

Remember, clinics are similar to restaurants, there are good ones and bad ones.

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Leave A Reply (22 comments so far)

  1. Bette Vidrine
    3 years ago

    I highly recommend McLeod Trahan Sheffield PT located in Scott, LA. My PT ther is Ellen Devalcourt. The therapy helped me so much I joined the wellness group after rehab stopped. All the therapists there are still available for me to ask questions and get help whenever I want or need it.

    • SpondyInfo
      3 years ago

      Thanks so much for the recommendation Bette! It sounds like you have found a great team to help you with your condition and that is over half the battle. Thanks for sharing for others and best of luck moving forward!

  2. Sunny
    3 years ago

    I would love to find a PT in New York City who could help me with my degenerative spondylolisthesis (grade 1, with some nerve impingement). I went to a top hospital’s back care center which dealt with nonsurgical techniques, but the PT exercises for the core they gave me did not help at all and in fact created a lot of pain in the SI joint area. The therapist tried to modify the exercises again and again, but did not succeed. I spent a lot of money and time and ended up limping, in pain, and taking over the country pain relief. I finally stopped the exercises and let the inflammation die down. It really made me scared to try PT again, but I do not want to have surgery and I don’t want to start the route of injections and taking prescription painkillers.

    Oh, and it is so true that so many people, lay people and even health care people such as PTs, seem to lump “back pain” in one category. People seem to lump acute back pain from isolated injuries or trauma in with chronic pain from a structural problem such as spondylolisthesis. It is frustrating.

    • SpondyInfo
      3 years ago

      Hi Sunny. I understand your frustration and hesitation to try PT again. But trust me, not all PT’s are alike. They have different levels of experience, different levels of education, different philosophies, etc. I highly encourage you to continue your search especially if you want to improve. Personally, I went through many different therapy experiences. Each one was different and it took a while to find help that knew how to approach this condition. My advice would be to “google” or search for an SFMA certified physical therapist in your area. Give that person or clinic a call and explain your situation and explain to them your interest in learning more about the role your movement may have with your pain. I explain more about how movement can affect your spondy here: https://spondyinfo.com/how-poor-movement-can-affect-your-spondy-and-how-to-fix-it/
      The SFMA is a great assessment tool that helps the practitioner locate potential problematic areas that may be affecting how you move. It also helps them look at the whole body instead of just the site of the pain. It is a great tool to look for when starting your search for spondy help. Our Spondy Improvement Path also takes you through steps on how to find a PT in your specific area. Let me know how your search goes and best of luck!

  3. Cindy Jackson
    2 years ago

    Just looking at this creates relief and I am going to try. I am at a complete loss with back pain. I have had fusion followed by laminectomy. Spondyinfo dx came by pain management MD but never addressed as source of pain. I diligently continue in my quest as disability is an option at this point. I do home health psych nursing and extended driving and sitting is the problem. Do you know of any cushions that could provide relief? BTW I have used a tennis ball on swollen hip area while driving which provided immediate relief but later caused excruciating pain. Very frustrating journey but really enjoy reading your info. Thank you

    • SpondyInfo
      2 years ago

      Hi Cindy. I am glad to hear our website is helping you. I understand your pain and frustrations, back pain can be so stressful. I am unaware of any cushioning that provides relief, but I have to be honest, I have never searched for any so my knowledge is limited in this area. I hope the site continues to provide you with a path towards improvement!

  4. sandy dwelley
    2 years ago

    Thanks for the info on physical therapy getting ready to see, this out .

    • SpondyInfo
      2 years ago

      No Sandy, let me know how it goes.

  5. Lisa michelson
    2 years ago

    Very helpful thank you … I have a double whammy with spondy and spinal stenosis… I was devastated wight be diagnosis. E aide I am a yoga instructor and probably made my condition worse because I was not aware of it until it became PAINFULLY obvious…. Massage and Chiropracter plus Accupuncture ha e. Even helping along with awareness but I really want to. Ego. Some type of rehab. How do we find a person who is able to help? What would I look for?
    Thank you Lisa Michelson

    • SpondyInfo
      2 years ago

      Hi Lisa.

      I have to resources that can help you with that question. 1.)https://spondyinfo.com/3-questions-to-ask-when-you-are-searching-for-spondylolisthesis-rehab/


      I hope these help, let me know if you have any questions!

  6. Lisa michelson
    2 years ago

    Lisa Michelson again,, lots of typos sorry..
    How do we find a person who could probably diagnosis out unique body situation when it comes to Spondy?? Thanks

    • SpondyInfo
      2 years ago

      Hi Lisa. I provide an answer to your previous question – which also answers this one. Hope it helps!

  7. Alex Hourahine
    2 years ago

    Totally agree Justin, it took me several changes in therapists before I found one who was willing to put in the time and work with me to develop a workout that did help. We have tried several exercises that we monitored for results. Some worked better than others. We continue to build up the exercise program using the exercises that are most effective.
    This process has only been going on for about six weeks. I can’t say I am totally pain free but I have had no major flare ups in this time and am able to continue with an active sports schedule. Keep up the great work Very Best regards Alex

    • SpondyInfo
      2 years ago

      Thats awesome Alex! That is the key, consistently monitoring what works and what does not along with adjusting to the constant changes. It sounds like you have a great therapist. Keep moving in the right direction and you will continue to see improvements. Thanks for sharing!

  8. Michele Rhodes
    1 year ago

    I have been going to physical therapy since September at Tudor Physical Therapy in Columbiana, OH. They do an excellent job of everything you recommend above. Even though the therapists are often managing 2 sometimes 3 patients at a time, it actually seems to be time efficient, because once we get the routine down, we don’t need as much 1-on-1, but they’re always close by and always checking in, to make sure we remember how many reps, how long to hold a stretch, good form, etc. Whenever I need to discuss issues with them they are always excellent at it and I can tell they are well-trained and know what they’re doing.

    I’ve been through PT several times in the past for other issues, so I know what to expect, and I am a “good patient” in that I follow their instructions carefully and do everything they ask.

    My spondy story is that I’ve been dealing with this chronic pain in my “hip and right leg” for several years now. I’m not even sure how far it goes back, and I still can’t identify a “traumatic” injury of any sort, MAYBE I fell on the ice a few years ago, but I can’t be sure and I don’t recall being laid up or anything.

    So in the fall of 2013 and 2014 I went for physical therapy for my right leg pain. We weren’t sure what it was: bursitis or sciatica, etc. The PT helped only a bit. Finally a year ago I told my primary care dr I wanted to see a specialist for the pain. That triggered a back x-ray, which showed no problems at all. The specialist is a rheumatologist and he ordered an MRI and sent me to a pain dr. The MRI didn’t show much, but the pain dr sent me for x-rays bending forward and back. That’s when they caught the spondy. I had injections, but they weren’t worth the needle pain of having them done.

    PT has helped strengthen my core, but I still have a lot of pain.

    • SpondyInfo
      1 year ago

      Thanks for sharing Michele! Finding the right therapy (a combination of a smart, knowledgeable therapist + someone you trust) can be very difficult. I hope you continue to improve!

  9. Susan France
    7 months ago

    Has anyone used an inversion table to treat spondylitis Grade 1?

    • SpondyInfo
      7 months ago

      Hi Susan,

      Personally I have not attempted to use an inversion table for my condition (isthmic spondylolisthesis grade 1) or ran across any studies on their benefits. Hopefully someone else can chime in with other comments in regards to your question.

  10. Jayne
    6 months ago

    My vertebrae has moved forward S1L4/5. I went to a structural integrative expert who taught me about movement, standing properly and utilizing my core for everything. She also gave me massages based on the zen body method which helped. Then, we moved to Palm Beach where I saw a chiropractor who “unwrapped” me and gave me exercises to do along with connecting me with a fabulous rehab center. Now I’m working with a trainer one day a week using the TRX a lot and other core/back strengthening techniques as well as stretching. I do these every morning and I walk 2-4 mikes almost every day. I’m much better and able to manage this pain. When I need to I take one aleeeve and so far I’m ok. I can’t play golf as much as I like but this has been a year or so journey. It’s takes time and patience. I know how hard this is but your updates are helpful. Thank you and I’m grateful to be connected to this community v

    • SpondyInfo
      6 months ago

      Great post Jayne! Thanks so much for sharing and it sounds like you have had some great help. Keep striving to improve and best of luck!

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