Spondylolisthesis | Back Pain Physiotherapy East Fremantle

Spondylolisthesis | Physiotherapy for Low Back Pain in East Fremantle


Spondylolisthesis refers to the slipping of part of all of one vertebrae forward on another. It is most commonly seen in children between the ages of 9 and 14, and in the vast majority of cases involves the L5 vertebrae slipping forward on the S1 vertebrae.

These injuries are graded according to the degree of slipping of each vertebrae.

spondylolisthesis, vertebrae, back pain, grades of spondylolisthesis

As illustrated in the diagram:

  • Grade 0: Normal Spine
  • Grade 1: 0-25% slippage of the top vertebrae on the bottom.
  • Grade 2: 26-50% slippage.
  • Grade 3: 51-75% slippage.
  • Grade 4: 76-100% slippage.
  • Grade 5: Complete slippage forward from the top vertebrae on the bottom.

Signs and Symptoms of a Spondylolisthesis

Grade 1 spondylolisthesis are often asymptomatic and many people are completely unaware of the defect. Patients with Grade 2 or higher defects often complain of the following signs:

  • Low back pain, which can be persistent or intermittent depending on activities
  • Buttock or thigh pain
  • Stiffness in the lower back or buttock
  • Tight hamstring and buttock muscles

On examination, your physiotherapist can often find a palpable dip corresponding to the level of the slip. Many soft tissue abnormalities are often present with this condition, including muscle weakness and tightness. A spondylolisthesis is a long term injury, and is often present long before the development of any back pain. As such it is important to determine whether your pain is resulting directly from the spondylolisthesis or from other structures.


Treatment of Spondylolisthesis

Treatment of this condition is generally non-surgical. Your physiotherapist can guide you through your rehabilitation, which generally consists of:

  • Rest from aggravating activities
  • Treatment of contributing factors – e.g. tightness through the gluteals, hamstrings, quadratus lumbrorum muscles
  • Abdominal, glute and extensor muscle training.

Athletes with a grade 3 or 4 spondylolisthesis may require a brace to be worn if there is evidence of the vertebral slip worsening.


Struggling with low back pain? Our physiotherapists are experts in assessing and diagnosing your low back pain and can provide a range of treatments to reduce your symptoms, including massage, joint mobilisation and dry needling, and deliver an individualised rehabilitation program to ensure your pain does not return.

Book in your appointment online today. 

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