What Is Spondylolisthesis?

Spondylolisthesis is the forward slippage of one vertebra over the one below it. Graded I (0-25%), II (25-50%), III (50-75%), IV (75-100%). Most presenting to physiotherapy is Grade I or II. L4-L5 and L5-S1 levels are most commonly affected.

Physiotherapy Treatment

Core Stabilisation

The cornerstone of management is lumbar stabilisation -- strengthening transversus abdominis and lumbar multifidus, which act as a natural internal brace. A graded core stabilisation programme significantly reduces pain and allows return to activity in most Grade I-II cases.

Activity Modification

Avoiding end-range lumbar extension, heavy axial loading, and impact activities in the acute phase. Activity modification is temporary -- the goal is progressive return to full activity once stability is established.

Postural Education

Avoiding positions that increase anterior shear: lumbar hyperlordosis, anterior pelvic tilt. Neutral spine posture in sitting, standing, and lifting.