Spondylolisthesis: when a vertebra slips and causes back pain

Back pain that worsens when standing or walking is not always related to the intervertebral disc, as is the case with a herniated disc. Sometimes, the cause is a shift in the position of one vertebra relative to the one below it.

This condition is called spondylolisthesis, and it occurs when a vertebra slips forward or, less commonly, backward relative to the adjacent vertebra. In adults, the problem may be caused by degenerative changes in the spine or by a defect in a portion of the vertebra.

Symptoms vary from person to person: some experience no symptoms at all, whilst others suffer from lower back pain, leg pain or numbness, and difficulty walking — particularly if the slipped vertebra compresses nearby nerve structures.

How it is treated

In most cases, treatment begins with conservative methods: physical rehabilitation and exercises that strengthen the trunk muscles and help manage pain. Surgery becomes an option when symptoms do not subside, significant spinal instability develops, or neurological problems arise.

Choosing the right treatment depends on the degree of vertebral displacement and, most importantly, on how greatly it affects the patient's daily life.