Spondylolysis is a stress fracture in a small bridge of bone at the back of a vertebra (the pars), most often at the bottom of the spine. Spondylolisthesis is when one vertebra slips forward on the one below, which can follow spondylolysis or develop with age-related changes. Many people with either condition have no symptoms, and most who do are managed without surgery.
Also known as pars defect, pars stress fracture, slipped vertebra, isthmic spondylolisthesis, degenerative spondylolisthesis
Symptoms
- Low back pain, often worse when leaning backwards or twisting
- In young athletes, back pain that builds with sport such as gymnastics, cricket bowling, dance or football
- Stiffness or tight hamstrings
- Leg pain, tingling or numbness if a nerve is irritated
- In older adults, leg symptoms on walking that ease with sitting (similar to spinal stenosis)
Causes and risk factors
- Repeated backward bending and twisting in sport, which can cause a pars stress fracture in adolescents
- Age-related changes in the discs and facet joints, leading to degenerative slippage in older adults
- Genetic and anatomical factors
- Degenerative spondylolisthesis is more common in women and in people over 50
What the evidence says helps
- A systematic review of athletes with spondylolysis found that around 9 in 10 returned to sport after conservative care such as activity modification, bracing and physiotherapy, typically after four to five months.2
- Spondylolysis was more common on scans in adults under 50 with back pain than without it, but spondylolisthesis was not clearly linked to pain, so scan findings need careful interpretation.3
- For people with degenerative spondylolisthesis and stenosis whose symptoms persist, a large trial found those who had surgery reported greater improvements in pain and function over eight years. Strict comparisons were limited because many people switched treatment groups.4
- A review comparing surgery with physical activity-based care found surgery gave better short- and longer-term results for spondylolisthesis, but the quality of evidence was low.5
Things you can try at home
- For young athletes, reduce or pause the sports movements that provoke pain and seek assessment early
- Stay active with movements that do not flare symptoms, such as walking, cycling or swimming
- Build strength in the trunk, hips and legs gradually
- Return to sport in planned stages rather than all at once
- Older adults with leg symptoms on walking can try shorter walks with rests and forward-leaning activities
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- Numbness around your genitals, bottom or inner thighs, or new bladder or bowel problems – go to A&E or call 999 immediately
- Weakness or numbness in both legs – seek urgent medical help
- Rapidly worsening leg weakness or foot drop – contact your GP urgently or NHS 111
- A child or teenager with back pain that is constant, wakes them at night or comes with fever or weight loss – see your GP urgently
- Back pain after a significant fall or accident – seek urgent medical help
How Apollo can help
We assess your back and how it responds to movement and sport, and help coordinate imaging through your GP when it is needed to confirm a diagnosis. For athletes, we provide load management, progressive strengthening and a staged return-to-sport plan. For adults with degenerative slippage, we offer exercise-based rehabilitation, hands-on care where suitable, and prehab or post-operative rehab if surgery is being considered.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
Can I play sport with spondylolysis?
Most athletes return to sport after a period of rest from provocative movements and a structured rehab programme. Research suggests about 9 in 10 return, often within four to six months. A graded return guided by a clinician helps reduce setbacks.
Will my spondylolisthesis get worse?
Many slips stay stable for years and cause few or no symptoms. Your clinician may monitor it if symptoms change. Increasing pain, leg symptoms or weakness should be reviewed.
What is the difference between spondylolysis and spondylolisthesis?
Spondylolysis is a stress fracture or defect in part of a vertebra. Spondylolisthesis is when a vertebra slips forward on the one below. Spondylolysis can lead to a slip, but slips also happen with age-related changes.
References
- Kalichman L et al. (2009). Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult community-based population. Spine. View source
- Grazina R et al. (2019). Return to play after conservative and surgical treatment in athletes with spondylolysis: a systematic review. Physical Therapy in Sport. View source
- Brinjikji W et al. (2015). MRI findings of disc degeneration are more prevalent in adults with low back pain than in asymptomatic controls: a systematic review and meta-analysis. American Journal of Neuroradiology. View source
- Abdu WA et al. (2018). Long-term results of surgery compared with nonoperative treatment for lumbar degenerative spondylolisthesis in the Spine Patient Outcomes Research Trial (SPORT). Spine. View source
- Fernandez M et al. (2016). Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis. European Spine Journal. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
