Retrolisthesis: What You Should Know

Retrolisthesis is a condition where the bones grow too quickly, causing them to break off from their normal position. If left untreated, it can lead to osteoporosis. There are several different types of retrolisthesis. Some are due to trauma or disease such as osteomyelitis (infection) and myositis (inflammation). Other types of retrolisthesis occur naturally and most often result from aging. These include fractures, arthritis, cancer and other diseases.

Symptoms of Retrolisthesis

The first sign of retrolisthesis is usually pain on standing up. This may be severe enough to cause you to fall down.

If you have any kind of joint problem, like arthritis or back problems, this could mean that your bones are growing too fast and breaking off from their proper positions. Sometimes the bone growths may not even show up until years after the injury occurred!

Other signs of retrolisthesis include:

Weakness in one or both legs.

A feeling of heaviness in your lower body. This may be accompanied by weakness in your arms and hands.

This could indicate that you have osteopenia (a decrease in bone mass), which means less bone tissue than when you were younger. Osteoporosis is another possible diagnosis if there is a loss of calcium (calcium builds up inside bones). If the bones aren’t strong enough to support the natural weight of your body, fractures and breaks can occur. This may even lead to paralysis or death.

How will your doctor test for retrolisthesis?

Your doctor will ask you questions about your medical history and perform a physical examination. He or she will look for:

Pain in your lower back and legs.

A loss of feeling in your legs or feet.

Swollen joints.


Your doctor will also ask you to walk and move around. He or she may add weight to your legs, such as by having you raise your leg against his or her hand.

Your doctor will be looking for pain, swelling and other symptoms. You may be given an x-ray or MRI to determine if there is a disease like cancer or arthritis at the root of the problem.

How is retrolisthesis treated?

There is no one single treatment that works for every person with retrolisthesis. Your doctor will discuss the best course of action with you based on your specific condition. If you have been diagnosed with a bone disease, like cancer or arthritis, then your main concern will be that disease. If you have a disease that could cause death or serious harm to your quality of life, then this should be treated first.

If you do not have a bone disease, then your main concern will be pain management and physical therapy. Physical therapy can help strengthen the muscles at the base of your spine and lower back.

These muscles support the bones of the spinal column and can take some of the pressure off your vertebrae.

Pain management is an important part of retrolisthesis treatment. The vertebrae in your lower back do not have a pain receptor, so the nerves that come from the damaged disc can send pain signals to your brain for up to a year after the initial injury.

Taking over-the-counter or prescription pain medication can ease these symptoms and make it easier to manage your condition.

In some cases, doctors may recommend surgery if other treatments are not feasible or effective. Surgery may be required to remove part of a herniated disc that is putting pressure on a nerve or if your vertebrae are becoming so weak they cannot support your body.

Can retrolisthesis be prevented?

While there is no way to prevent a retrolisthesis episode from happening in the first place, you can take steps to avoid injuring yourself in the future. Take it easy when you’re recovering from an injury or illness. Don’t try to lift heavy boxes or do other activities that may strain your back. When you’re lifting, twist, or reaching, give yourself plenty of time so you don’t have to rush and put your back out of alignment.

If you have a job that requires you to be in an uncomfortable position for long periods of time, take breaks and change positions often. Your employer must provide a safe working environment for you under the OSH Act.

If your employer requires you to do something illegal or violates workplace safety laws, report them.

If you smoke, quit. Smoking can make the vertebrae in your spine deteriorate and become weaker, making them more susceptible to retrolisthesis.

It’s never too late to quit and your health will benefit almost immediately.

How long does retrolisthesis last?

The most common form of retrolisthesis usually lasts less than a year. If you have a sudden injury or herniation in your back, your condition can last anywhere from six weeks to several years. If you’ve had a condition since childhood or have degenerative disc disease, your condition may be permanent as the damaged discs will continue to weaken and cause retrolisthesis.

Can I have a normal life?

Yes. Most people can lead regular lives with retrolisthesis as long as they take the appropriate steps to manage their condition. If you are uncomfortable, talk to your physician about treatment options. The most important thing for you to do is keep yourself safe and avoid reinjuring your back.

What is the outlook for retrolisthesis?

The outlook for most forms of retrolisthesis is favorable. Most people with herniated discs or other conditions that cause retrolisthesis recover fully without any lasting complications. However, if you have more than three lumbar vertebrae affected by retrolisthesis, if your sacrum is involved, or if there is cauda equina syndrome, your outlook is less certain. In these cases, more aggressive treatment may be required.

Can retrolisthesis cause additional complications?

One of the main complications of retrolisthesis is that it can cause other medical issues. For example, if you have a herniated disc at L5 and are experiencing pain in your right leg, you may initially think that it’s just part of the underlying condition. In reality, the spinal nerve roots at L5 are providing sensation and motor function to the lower extremities along with controlling important bodily functions like urination and defecation. Any interference in this area can cause serious complications.

If you are experiencing any of these symptoms, consult your physician immediately as they could be signs of additional issues.

How do I know if I need a specialist?

For most people with retrolisthesis, a primary care physician or general surgeon will work just fine. If you are experiencing numbness, tingling, or loss of bowel or bladder control, see a neurosurgeon immediately. These can be signs that more serious damage has been done to your nerves and may require immediate action.

What precautions should I take?

As with any condition, the most important thing for you to do is to avoid reinjuring your back. If you do everything in your power to protect your back, over time the herniated discs will heal and the retrolisthesis will correct itself. Follow these tips to protect your back:

Avoid activities that require heavy lifting.

Avoid contact sports, especially those that involve a lot of twisting or turning.

Don’t sit or stand in the same position for long periods of time. Get up, stretch, and walk around at least once every hour.

Don’t stand for long periods of time. If you must stand, support yourself with a back support while doing so.

You can also use a footstool to take some of the pressure off of your legs.

Use XL Extra Strength Glute Max strengthens and lifts your butt, hips and thighs! If you’re suffering from lower back pain or are prone to it due to retrolisthesis, these exercises will help strengthen the muscles that support the spine.

They’ll also build up the muscles in your back, hips, and legs; this extra strength will help take pressure off of the spine and reduce pain.

Sit on the floor with your legs out in front of you, knees straight but not locked. Cross your left leg over your right leg.

Loop a resistance band around your left ankle. While sitting up straight, pull the ends of the band with your left hand to bring your left knee toward your chest. Hold the position for a count of two and then extend your leg straight out while continuing to pull with the band. Make sure to keep your knee pointed directly up toward the sky, don’t allow it to bend forward. Perform this exercise on your right side. Continue alternating for a total of 50 reps.

This is a great exercise to strengthen your butt, hips, and thighs while taking pressure off of your lower back. While sitting on the floor, loop a resistance band around your legs just above your knees.

You can do these with your knees straight or you can bend your knees. For more of a challenge, bend your knees. For an even greater challenge, try to lift your knees as high as you can without allowing your lower back to hump outward or arch inward.

These are just two of several exercises you can do to strengthen the muscles in your back, hips, and legs. For more exercises, check out SparkPeople’s Resistance Band Workout.

Spend a few minutes on these muscles each day and your lower back pain should subside in a few weeks or months at the most. If you are still experiencing pain, you may also want to consult your doctor or a spine specialist.

Sources & references used in this article:

Exploratory evaluation of the effect of axial rotation, focal film distance and measurement methods on the magnitude of projected lumbar retrolisthesis on plain film … by RR Coleman, EJ Cremata Jr, MA Lopes… – Journal of chiropractic …, 2014 – Elsevier

The Truth About Adult Scoliosis: What You Need to Know About History, Treatment Options, and How to Prevent Progression by A Strauss – 2018 –

Cervical Spine: Tricks and Traps: 60 Radiological Exercises for Students and Practitioners by JF Bonneville, F Cattin – 2012 –

MR imaging and radiographic imaging of degenerative spine disorders and spine alignment by F Galbusera, A Lovi, T Bassani… – Magnetic Resonance …, 2016 –

Iconography and Text with Corresponding Schemes by JF Bonneville, F Cattin – Cervical Spine: Tricks and Traps, 1990 – Springer

Spinopelvic sagittal balance: what does the radiologist need to know? by LG Savarese, R Menezes-Reis, GP Bonugli… – Radiologia …, 2020 – SciELO Brasil

Risk factors of radiological adjacent disc degeneration with lumbar interbody fusion for degenerative spondylolisthesis by T Tsuji, K Watanabe, N Hosogane, N Fujita… – Journal of Orthopaedic …, 2016 – Elsevier

How I Thought Myself into Illness, Then Thought My Way Out by D Grinnell – Perspectives in biology and medicine, 2019 –

Pain immediately upon sitting down and relieved by standing up is often associated with radiologic lumbar instability or marked anterior loss of disc space by JY Maigne, E Lapeyre, G Morvan, G Chatellier – Spine, 2003 –