Spondylosis, Spondylolysis & Spondylolisthesis: What They Mean and How Physiotherapy Can Help Back Pain

If you’ve ever experienced low back pain or stiffness, you’ve likely come across complex terms like spondylosis, spondylolysis, and spondylolisthesis—whether through a quick Google search or from a healthcare professional. While these medical terms may sound intimidating, understanding them is key to effective management and recovery.

Whether you're an athlete, a weekend warrior, or someone who simply enjoys staying active, knowing how to address these issues on your own—and when to seek physiotherapy—can help alleviate symptoms and get you back to doing what you love. In this article, we’ll break down these diagnoses, offer reassurance, and provide insight into how you can return to your favourite activities with confidence. What is the Spine?

The spine (with the prefix “spondy-,” derived from Greek, meaning spine) is a column of bones that runs from the neck to the lower back. It consists of 33 small bones called vertebrae, stacked on top of each other. The spine has three main sections:

Cervical spine (neck)

Thoracic spine (mid-back)

Lumbar spine (lower back)

Between the vertebrae are soft, cushion-like discs that help absorb shock and allow movement. The spine supports the body, protects the spinal cord (which sends signals between the brain and body), and enables us to move, bend, and twist.

What Do These Terms Mean?

Spondylosis (Degenerative Changes)

Spondylosis is an age-related condition often referred to as spinal arthritis. It involves the gradual breakdown of cartilage, discs, and bones in the spine, potentially leading to stiffness, reduced mobility, and sometimes nerve irritation.

Common Symptoms:

• Back or neck pain
• Stiffness, especially in the morning
• Reduced movement of the back or neck
• Occasional nerve pain or tingling in the limbs

Spondylolysis (Stress Fracture)

Spondylolysis (with the suffix “-lysis,” meaning “break”) is a small stress fracture in the vertebra, usually in the lower back. It’s common among young athletes whose sports involve repetitive hyperextension of the spine (arching backward).

Common Symptoms:

• Localised lower back pain
• Pain worsens with activity, especially back bending

Spondylolisthesis (Fracture and Vertebral Slippage)

Spondylolisthesis (with the suffix “-listhesis,” meaning “slip”) occurs when a vertebra slips forward over the one below it, often due to untreated spondylolysis or degenerative changes.

Common Symptoms:

• Lower back pain
• Nerve compression symptoms (numbness, tingling, weakness in legs)
• Pain worsens with standing or walking

Self-Management Strategies

To manage symptoms effectively, it’s advisable to temporarily reduce activities that trigger discomfort. For example, if symptoms occur during overhead tennis serves, it may be necessary to pause competitive matches and overhead serving until the discomfort becomes more manageable.

However, complete rest is not recommended. Instead, focus on maintaining movement through strength and cardiovascular exercises. Once symptoms subside, the movement—such as overhead serves in this case—can be gradually reintroduced, starting with a limited number of serves at reduced intensity before progressing further.

When to Seek Physiotherapy?

You should consider physiotherapy if:

• Pain persists beyond a few weeks.
• Your activity levels are significantly affected due to discomfort.
• You’ve had repeated flare-ups of back pain with movement.

How Can Physiotherapy Help?

A physiotherapist plays a crucial role not only in diagnosing and explaining conditions like spondylosis, spondylolysis, and spondylolisthesis, but also in developing a personalised treatment plan that addresses each patient's unique needs. Through a comprehensive assessment, they evaluate the severity of symptoms, the range of motion, and the strength of muscles surrounding the spine. This thorough examination helps inform the approach to rehabilitation.

A key part of the physiotherapist’s role is educating patients about their condition, so they can better understand how it affects their body and what steps they can take to manage their symptoms. This education empowers patients to make informed decisions about their movement, posture, and exercise habits, which can significantly reduce pain and prevent further injury.

Ultimately, the goal is to give patients the tools they need to stay active and independent while preventing the recurrence of symptoms. With the right guidance, physiotherapy not only helps manage the immediate pain but also lays the foundation for a healthier, more resilient spine in the long term.

Conclusion

While these spinal conditions may sound complex, they are manageable with the right approach. Early intervention through physiotherapy can help you stay active, reduce pain, and prevent further complications. Don’t let back pain hold you back—book a physiotherapy assessment today to get personalised guidance and start your journey to recovery!

References

Spine Anatomy & Function

• TeachMeAnatomy. (n.d.). Vertebral Column – Structure & Function.
• Kenhub. (n.d.). Spinal Column Overview.

Spondylosis (Degenerative Changes)

• Mayo Clinic. (2023). Spondylosis (Spinal Osteoarthritis).
• Spine-Health. (2023). Cervical and Lumbar Spondylosis.

Spondylolysis (Stress Fracture)

• Radiopaedia. (n.d.). Spondylolysis - Causes & Diagnosis.
• National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). (2023). Spondylolysis in Young Athletes.

Spondylolisthesis (Vertebral Slippage)

• Cleveland Clinic. (2023). Spondylolisthesis – Symptoms, Diagnosis & Treatment.
• American Academy of Orthopaedic Surgeons (AAOS). (2023). Spondylolisthesis: A Common Cause of Back Pain.

Physiotherapy for Back Pain & Rehabilitation

• Chartered Society of Physiotherapy (CSP). (2023). Managing Back Pain with Physiotherapy.
• Spine-Health. (2023). Exercise and Rehabilitation for Spondylolysis & Spondylolisthesis.