Spondylolysis and Spondylolisthesis Care
Spondylolysis and Spondylolisthesis Care at
At Marsden Park Chiropractic, we frequently see people who suffer from back pain caused by spinal stress or slippage conditions such as spondylolysis and spondylolisthesis. These conditions can impact mobility, strength, and quality of life — but with the right care, many people can return to feeling and moving better.
Other
Back Pain
Neck Pain
Headaches & Migraines
Sciatica
Sports Injuries
Posture Problems
Slipped Disc
Workplace Injuries
Neck Pain
- Whiplash
- Non-specific Neck Pain
- Torticollis
What is Spondylolysis?
Spondylolysis is a stress injury or defect in the pars interarticularis – part of the bony arch of the spine.
- More common in adolescents and young athletes
- Pain is often triggered by extension (bending backwards) or high-load activities
- Can usually be identified with MRI early, before the stress develops into a complete fracture
What is Spondylolisthesis?
Spondylolisthesis refers to a vertebra slipping forward in relation to the one below it.
- Can follow spondylolysis, or occur later in life due to degenerative changes in discs and facet joints
- Common in both active adolescents and older adults
- May cause aching, stiffness, or nerve irritation depending on severity
Clinical
At Marsden Park Chiropractic, the first step is always accurate assessment.
History:
age, activity levels, onset of symptoms, aggravating movements
Examination:
mobility, stability, neurology, pain provocation
Investigations:
- MRI to detect bone stress, disc issues or nerve involvement
- X-rays (including flexion/extension films) to check for vertebral slip or instability
Surgical Thresholds
- 4 mm of vertebral translation on flexion/extension X-rays
- 8% displacement between movements
- 10° change in disc angle across movements
- Clear evidence of progressive neural compromise
Spectrum of Injury
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Early stress reaction Pars/pedicle bone stress (detected on MRI). Usually reversible with rest.
Partial or complete fracture May lead to slippage if untreated. Healing possible with rest and rehab.
Chronic non-union (isthmic spondylolisthesis) Slippage occurs, often stable after adolescence.
Degenerative spondylolisthesis Later in life due to wear of discs and facet joints, more prone to instability.
Treatment Goals at
Our approach focuses on conservative methods such as:
Preserving spinal health
joint mobility, disc nutrition, reducing shear stress
Neuromuscular activation
stabilising deep core and spinal support muscles
Sensory-motor training
improving proprioception, balance, and spinal control
Load distribution
enhancing SI joint and limb function to reduce stress on lower back
Lifestyle & education
ergonomic advice, activity modifications, and exercise rehabilitation
Every care plan is patient-centred and goal-driven.
Summary Table: Adolescent vs Degenerative Spondylolisthesis
| Feature | Adolescent / Isthmic (pars stress) | Degenerative (older adults) |
|---|---|---|
| Onset | Sudden, often sport-related | Gradual, age-related |
| Source of slip | Pars defect / fracture | Facet & disc degeneration |
| Pain behaviour | Worse with activity/extension, better at rest | Worse with prolonged standing/walking, eased by sitting |
| Best investigation | MRI for stress & early changes | Flexion/extension X-rays for instability; MRI for stenosis |
| Progression | Usually stabilises by adulthood | May worsen with disc collapse or facet instability |
| Prognosis | Good if detected early and managed | More variable; risk of progression |
| Management focus | Rest, healing, gradual return to activity | Stability, core control, conservative rehab; surgery only if severe |
The Big Picture
- Early MRI in young athletes can prevent a lifelong slip by catching stress reactions.
- Functional radiographs in older adults are the gold standard for identifying instability.
- Isthmic spondylolisthesis usually stabilises after adolescence.
- Degenerative spondylolisthesis often requires careful management of instability and degeneration.
- The vast majority of patients can be safely managed with conservative, non-surgical chiropractic care.
Frequently Asked
Can spondylolysis heal on its own?
Yes — if detected early and managed with rest, most adolescent stress reactions heal completely.
How do chiropractors support degenerative spondylolisthesis?
By improving joint control, reducing muscular guarding, and teaching stabilisation strategies to take pressure off unstable segments.
Do all slips progress to severe cases?
No. Isthmic slips usually stabilise by adulthood. Degenerative slips may progress, but with care and monitoring many remain well-managed.
Is surgery always needed if nerves are involved?
Not always. Surgery is considered if conservative care fails or there is severe, progressive neurological compromise.
Take the Next Step
If you’re looking for safe, personalised and evidence-informed chiropractic management of spondylolysis or spondylolisthesis, contact Marsden Park Chiropractic today.
Book your consultation now — let’s get your spine moving with confidence.
