A Spondylolisthesis Is Not Always Relevant

A spondylolisthesis can be present and not be related to your symptoms - just like imaging can show non-painful degenerative changes, tears, etc. It sounds scary, but in the absence of recent trauma, there's a strong chance you have a spondylolisthesis that doesn't matter.

Competent clinical reasoning and testing can differentiate if a spondylolisthesis is or is not the generator of symptoms. I find repeated movement testing to be the most valuable method. Physical therapy will not fix a spondylolisthesis, which is a bony structural problem, but can help. However, physical therapy can usually fix other spinal problems, which may be producing your symptoms. An image shows you what’s there, but it doesn’t usually tell you what’s causing symptoms. That’s why you always need competent clinical reasoning and movement testing. -- Laura