Spondylolisthesis Exercises to Decrease Pain
Manhattan Physical Therapy
Why Exercises Matter for Spondylolisthesis Pain Relief
Spondylolisthesis is a common spinal condition that often causes lower back pain, stiffness, and nerve symptoms such as sciatica. While the diagnosis can sound alarming, research consistently shows that targeted exercise and physical therapy are highly effective for most mild to moderate cases.
A systematic review published in Sports Physical Therapy found that structured exercise programs improved pain and function in patients with low-grade spondylolisthesis, often reducing the need for injections or surgery. Another study in Spine reported that over 70% of patients experienced meaningful symptom improvement with conservative care, including exercise and activity modification.
The key is choosing the right exercises—movements that stabilize the spine without increasing stress on the slipped vertebra. When done correctly and consistently, these exercises can reduce pain, improve daily function, and help you move with confidence again.
What Is Spondylolisthesis?
Spondylolisthesis occurs when one vertebra slips out of alignment over the vertebra below it. In the lumbar spine (lower back), this slippage can irritate nearby nerves, leading to back pain, leg pain, or sciatica-like symptoms.
Most cases involve forward slippage, known as anterolisthesis, though backward slippage (retrolisthesis) can also occur. The condition is commonly diagnosed through specialized X-rays, and in some cases, MRI scans are used to assess nerve involvement.
According to population studies, spondylolisthesis affects approximately 6–11% of adults, with higher prevalence in people over 50 due to age-related spinal changes. While the condition can appear in the neck, it most often affects the lower lumbar spine, where it places stress on stabilizing muscles and joints.
Common Symptoms of Lumbar Spondylolisthesis
Symptoms vary widely. Some people have visible slippage on imaging with little discomfort, while others experience persistent pain that interferes with daily life. Common symptoms include:
Lower back pain that worsens with standing or arching the back
Stiffness or tightness in the lower spine
Tight hamstrings that limit flexibility
Pain in the buttocks, thighs, or legs
Numbness, tingling, or weakness in the legs (when nerves are irritated)
Clinical research shows that symptom severity often correlates more with spinal instability than the degree of slippage itself, which is why strengthening and stabilization exercises play such a critical role in recovery.
How Exercise Helps Stabilize the Spine
The spine relies heavily on deep core muscles, including the transverse abdominis and multifidus, to maintain stability. In people with spondylolisthesis, these muscles are often weak or delayed in activation, allowing excessive motion at the affected spinal segment. Targeted exercises help by:
Improving spinal stability and control
Reducing abnormal movement between vertebrae
Decreasing nerve irritation and leg pain
Improving posture and movement mechanics
Supporting long-term spine health
A 2013 clinical review found that patients who followed supervised stabilization programs reported significant reductions in pain and disability within 6–12 weeks. Low-impact activities such as walking, cycling, and swimming further support recovery without overloading the spine.
The exercises that follow are designed to minimize stress on the lower back while improving strength, flexibility, and control—key elements for managing spondylolisthesis safely.
Best Spondylolisthesis Exercises to Decrease Pain
The exercises below are commonly recommended for lumbar spondylolisthesis because they promote spinal stability without excessive extension or shear forces. These movements should feel controlled and comfortable. None of them should increase back or leg pain.
If pain worsens during or after exercise, stop and consult your physical therapist or healthcare provider.
Pelvic Tilt (Posterior Pelvic Tilt)
Pelvic tilts are one of the safest and most effective exercises for spondylolisthesis. They place the spine in a slightly flexed position, which often reduces pressure on irritated nerves.
How to perform:
Lie on your back with knees bent and feet flat on the floor
Gently flatten your lower back into the floor by tightening your abdominal muscles
Hold for 5–10 seconds while breathing normally
Relax and repeat 10 times
Research shows that lumbar flexion–based stabilization reduces pain and improves spinal control, especially in people with low-grade slippage.
Abdominal Bracing With Marching
This exercise trains deep core muscles that help stabilize the spine during everyday movements like walking or lifting.
How to perform:
Lie on your back with knees bent
Tighten your abdominal muscles as if drawing your belly button toward your spine
Keep your lower back gently pressed into the floor
Slowly lift one foot off the floor, then lower it
Alternate legs for 10–15 repetitions
Single Knee to Chest
This gentle stretch helps relieve tension in the lower back and hips while maintaining spinal alignment.
How to perform:
Lie on your back and perform a pelvic tilt
Bring one knee toward your chest and hold for 20–30 seconds
Switch sides and repeat 2–3 times
This movement is often helpful for patients who feel stiff or tight after prolonged sitting.
Hamstring Stretch
Tight hamstrings are extremely common in people with spondylolisthesis and can increase stress on the lower back.
How to perform:
Lie on your back and lift one leg straight up
Hold behind the thigh or knee
Gently pull until you feel a stretch along the back of the leg
Hold for 30 seconds and repeat 2–3 times per side
Studies show that improving hamstring flexibility can reduce lumbar strain and improve movement mechanics.
Child’s Pose (Modified if Needed)
Child’s pose gently stretches the spine while encouraging relaxation and reduced muscle tension.
How to perform:
Kneel on the floor with knees apart
Sit back toward your heels
Reach arms forward and relax your chest downward
Hold for 30–60 seconds
If kneeling is uncomfortable, a pillow under the knees can help.
Side Plank on Knees
Side planks strengthen the oblique muscles, which play a major role in controlling spinal rotation and side bending.
How to perform:
Lie on your side with knees bent
Support your body on your forearm and knees
Lift hips while keeping your body in a straight line
Hold for 10–20 seconds
Repeat 2–3 times per side
Progressions should only be done under professional guidance.
Exercises to Avoid With Spondylolisthesis
Certain movements can increase stress on the slipped vertebra and worsen symptoms. These typically include:
Repeated spinal extension (deep back bends)
High-impact activities like running on hard surfaces
Heavy squats or deadlifts without proper supervision
Sit-ups or leg raises that arch the lower back
Physical Therapy Treatment for Spondylolisthesis
Physical therapy is considered the first-line treatment for most cases of lumbar spondylolisthesis, especially when symptoms are mild to moderate.
According to clinical guidelines and published studies, conservative care leads to symptom improvement in the majority of patients, often within 8–12 weeks.
What Physical Therapy Focuses On
A comprehensive physical therapy program typically includes:
Spinal stabilization training to reduce abnormal movement
Core and multifidus muscle activation to improve support
Flexibility work for hamstrings, hips, and calves
Postural education for sitting, standing, and sleeping
Activity modification strategies to prevent flare-ups
A study published in the Journal of Orthopaedic & Sports Physical Therapy found that patients who completed supervised stabilization programs experienced significant improvements in pain, function, and quality of life compared to those who relied on rest alone.
When Is More Aggressive Treatment Needed?
While most patients respond well to exercise and physical therapy, some may require additional care. This may include:
Spinal injections for persistent nerve pain
Short-term bracing in select cases
Surgical consultation for high-grade slippage or progressive neurological symptoms
Surgery is generally reserved for severe cases that do not respond to conservative treatment.
When to Seek Medical Attention
Stop exercising and consult a healthcare professional if you experience:
Worsening leg pain or weakness
Numbness or tingling that progresses
Difficulty walking or standing
Loss of bowel or bladder control
What Do They Say About Us?
Alexander Liu
"Everyone on the team at Manhattan Physical Therapy is super nice and caring. They were able to pretty quickly diagnose my knee and hip problems and immediately put me to work to reduce the pain.."
Henry Myerberg
"You're not just a patient when you come to the Manhattan Physical Therapy. You feel like family there. In particular, Erica with her colleagues John, Lidia and Joe not only fix and improve you physically, they make you feel welcomed and cared for.."
Hakyung Kim
"Everyone is so kind and helpful! my knee and hip pain have improved massively since starting Manhattan PT, highly recommend to anyone. special thanks to Bianca, Lidia, Joe, and John!"
Manhattan Physical Therapy
✆ Phone (appointments):
(212) 213-3480
Address: 385 5th Ave, Suite 503, New York, NY 10016
