Spondylolisthesis

Your treatment will depend on the severity of your spondylolisthesis. People with grade 1 or 2 spondylolisthesis can usually be treated using nonsurgical approaches—many from the comfort of your own home, with guidance from your doctor at regular follow-up appointments. If you are overweight, your doctor may recommend achieving and maintaining a healthy weight, which will take pressure off your spine.

Stretching

People with spondylolisthesis often have tight hamstrings. There are stretches you can do to elongate these muscles in the backs of your thighs, such as a reclining leg stretch:

• Lie on your back in a comfortable spine posture. Bring one knee perpendicular to the floor and wrap a yoga strap or soft belt around the sole of your foot. Extend the leg overhead, while leaving the other leg flat on the floor.
• Grasping both sides of the strap, with the back relaxed, slowly straighten your lower leg until you feel a stretch in the back of the thigh. Hold 15-30 seconds, repeat 2 times.
• As you become more flexible, you can deepen the stretch by pulling the leg in the strap closer to you while it is straight.
• Consult your physician or physical therapist prior to starting any new exercises. All exercises should be pain-free.

Exercises

Spondylolisthesis exercises typically focus on stretching and core strength. Your doctor or physical therapist will let you know which ones are most likely to be effective for you.

• Stretching exercises may include stretching of the neck, hamstrings, quads (front of thighs), hips, and chest muscles.
• Strengthening exercises target the back, abdominal, and hip muscles and build a strong core.
• Cardiovascular exercises may include stationary cycling, jogging, and water exercises. You may be advised to avoid activities that put too much stress on your spine, such as heavy weightlifting and high-impact sports like football.

Back braces

Your recovery may be enhanced by the use of a back brace for spondylolisthesis. It immobilizes the part of your upper or lower spine with a slipped vertebra. It may also provide support and reduce pain during physical therapy. You may need to wear the brace periodically for several weeks or months; the brace will be custom-made to fit you and you will learn how often to wear it.

Massage therapy and physical therapy

You may find relief of your symptoms from a licensed massage therapist, whose techniques may enhance blood flow, loosen muscle knots, and relieve pressure on the spine using special approaches. Be sure to tell your massage therapist about your spondylolisthesis: its location, severity, and symptoms.

Physical therapy for spondylolisthesis can help you learn about proper alignment of the spine and approaches to move safely while teaching you ways to improve strength, posture, range of motion, and flexibility. Components of physical therapy will include exercises you learn with your therapist and do at home to stretch and strengthen your muscles. Your therapist will choose and teach you the exercises that are most effective for you.

Over-the-counter medications

Over-the-counter medications may be used to relieve spondylolisthesis pain. The medication recommended by your doctor will depend on the type, location, duration, and severity of your back pain. These medications include:

• Acetaminophen
• Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen
• Muscle relaxers
• Neuropathic (nerve) medications

If you are already taking large doses of some of these medications to try to relieve back pain, it may be time to see a doctor.