Lumbar spondylolisthesis can cause lower back pain and compress nerve roots, leading to numbness or leg pain. In addition to spinal surgery, committing to rehabilitation exercises remains one of the most effective ways to manage and alleviate symptoms of lumbar spondylolisthesis.
Introduction
From my clinical experience, patients with lumbar spondylolisthesis generally see limited improvement with treatments such as lumbar traction, acupuncture, or herbal medicine, as these methods do not reposition the displaced vertebrae. While traditional Chinese medicine (TCM) techniques can realign the vertebrae temporarily, the spine often shifts out of alignment shortly afterward. This occurs because the surrounding muscles and ligaments have adapted over time to the misaligned position.Therefore, it is essential to first relax the muscles and ligaments around the spine before attempting realignment, as this helps the vertebrae maintain their correct position. However, multiple sessions may still be needed to achieve lasting stability.
There is a saying in TCM: “Thirty percent treatment, seventy percent self-care,” meaning that recovery for any condition—whether internal or orthopedic—largely relies on the patient’s own efforts. In the following sections, I will share specialized techniques passed down from my spinal alignment mentor and unique methods I have developed over the years. By practicing these techniques consistently at home, those with lumbar spondylolisthesis may find relief and potentially avoid surgery.
Exercise 1: Double-Leg Lift and Double-Leg Press Down
Lumbar spondylolisthesis can be classified as either an anterior slippage, where the vertebra shifts forward toward the abdomen, or a posterior slippage, where it shifts backward toward the lower back, with the former being more common.Story continues below advertisement
To better understand this exercise, picture your hips as the rounded part of a spoon and your legs as the spoon’s handle. When you press the handle down, the rounded end lifts up; when you raise the handle, the rounded end tilts downward.
Posterior slippage (slipping backward)
This exercise utilizes the lever principle: as you lift your legs, gravity pulls them downward, with the hips acting as the pivot point. This creates a counterforce that encourages the slipped vertebra to shift forward, bringing it back into alignment.
Steps:
- Lie on your back with your legs together.
- Raise your legs to a 30-degree angle, hold for seven seconds, then lower them back down.
- Rest briefly and repeat the exercise for 14 repetitions.
When performing this movement, engaging the abdominal muscles is necessary to keep both legs lifted together, which also helps strengthen them. Stronger abdominal muscles can support the stability of the lumbar spine.
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For best results, focus on engaging the lumbar area and feeling a gentle forward push on the vertebrae. Adjust the height of your leg lift based on the location of the slippage, aiming to feel the counterforce at the affected vertebra (30 degrees is just a general guideline).
Anterior slippage (slipping forward)
This is a unique exercise I developed that may benefit those experiencing anterior slippage.
Steps:
- Place both lower legs on a half-round foam roller, adjusting the height so that the counterforce targets the forward-slipped vertebra.
- Gently press your lower legs down onto the foam roller, using only light pressure.
Exercise 2: Knee-to-Chest Hold
After completing the above exercise, you may experience soreness in the lower back muscles. To relieve this tension, perform a “knee-to-chest hold” stretch. For those with lumbar spondylolisthesis, any movement that arches the back is not recommended, as it can worsen vertebral slippage. In contrast, the forward-bending motion of the knee-to-chest position can effectively alleviate symptoms.Steps:
1. Prepare three straps and wrap them above the knees, below the knees, and above the ankles. If using three straps feels excessive, wrap at least one below the knees for added stability to ensure proper form.Story continues below advertisement
2. Lie on your back, holding both knees with your hands or gripping the strap below the knees. Gently shake your legs toward your abdomen 20 times as a warm-up.
3. Firmly hold your knees or the straps and pull your legs toward your abdomen, bringing your head as close to your knees as possible. Hold for three seconds, then relax, returning your head and knees to the starting position. Repeat this movement 20 times.
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4. Repeat Step 2 as a cool-down movement to relax the muscles.
5. With your feet together, gently sway your legs from side to side 20 times to help release tension and increase flexibility.
Exercise 3: Prone Stretch on Half-Round Foam Roller
This exercise is a specialized technique taught to me by my spinal alignment mentor. First, it is important to identify the location of your vertebral slippage. In most cases, slippage occurs between the third and fourth lumbar vertebrae (L3–L4), the fourth and fifth lumbar vertebrae (L4–L5), or between the fifth lumbar vertebra and the sacrum (L5–S1).Story continues below advertisement
Each region generally aligns with an area on the front of the body:
- The L4–L5 region corresponds approximately to the level of the navel.
- The L3–L4 region corresponds to an area about two finger widths above the navel.
- The L5–S1 region corresponds to an area about two finger widths below the navel.
Steps:
- Assuming the slippage is between the fourth and fifth lumbar vertebrae (whether forward or backward), position your navel over the highest point of a half-round foam roller and lie face-down.
- To maintain the natural arch in your body, let your upper body sink as low as possible and place your forehead on the bed. Position your arms on either side of your head, and spread your legs apart so that your hips shift back and sink down.
- Next, practice diaphragmatic breathing, allowing your abdomen to expand with each inhale and contract with each exhale. Aim for deep, slow breaths to create a gentle rise and fall in the lower back.
- Refrain from lifting your hips as you breathe. Instead, keep them pressed back and down to maintain the arch in your lower back, allowing the slipped vertebra to decompress.
Prone Stretch on Half-Round Foam Roller. The Epoch Times
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It is recommended to perform this exercise two to three times a day for 15 minutes per session. If you experience any discomfort during the exercise, start with five minutes per session and gradually increase the duration.
Precautions:
- Always perform this exercise on an empty stomach—ideally before meals, upon waking, or at least two hours after eating. Pressure on a full stomach can cause discomfort or even lead to acid reflux.
- Some people may experience dizziness or muscle soreness in the neck, shoulders, or upper back while lying on the foam roller, usually due to tightness in these areas. To relieve this, start with a cervical spine self-treatment routine to loosen the muscles and ligaments. Additionally, while lying face-down, position your head so it extends slightly over the edge of the surface, which can reduce pressure on the cervical spine and help alleviate dizziness.
- Mild soreness in the lower back or numbness in the legs is normal during this exercise—it is part of the stretching process and should ease after a few days of consistent practice. Many people find that, over time, this stretching helps decompress the lumbar spine, relieving nerve pressure and thus reducing back and leg pain. This method is gentle and generally has few adverse effects. However, if symptoms worsen after five days of practice, this approach may not be suitable for you, and it is best to discontinue the exercise.
Principle of Exercise 3:
The spine is made up of vertebrae stacked one atop the other, forming a natural arch, much like an arched bridge. If one of the stones in an arch bridge protrudes, it needs to be repositioned, but simply hammering it back or applying vertical stretching is not effective. Instead, when the entire arch moves rhythmically, the stones naturally realign, allowing the protruding stone to settle back into place.Think of the slipped lumbar vertebra as a stone that has shifted out of alignment. When you lie on the foam roller, your lumbar spine forms a gentle arch. Through diaphragmatic breathing, the muscles and ligaments around the vertebra—from surface to deep layers—continuously contract and relax with each inhale and exhale. This rhythmic motion releases deep muscle tension and gradually guides the vertebra back into alignment. However, this process takes time; consistent daily practice is necessary for improvement.
Dimensions of a Half-Round Foam Roller:
The foam roller typically measures 20.5 inches (52 cm) in length, 10.6 inches (27 cm) in width, and 9 inches (23 cm) in height. The sides, at 4.5 inches (11.5 cm) high, taper toward the center to form a rounded arc at the highest point. Additionally, it is filled with high-density foam. Regular pillows are usually too soft and lack the necessary support for these exercises.
Dimensions of a Half-Round Foam Roller. The Epoch Times
Effectiveness of Exercise 3:
Based on my clinical experience, this exercise is more effective for patients with relaxed lower back muscles, while those with tight lumbar muscles tend to recover more slowly. In such cases, traditional Chinese herbal medicine that relieves muscle rigidity and activates collaterals can help ease the tension.Story continues below advertisement
About one-third of patients with vertebral slippage achieve full realignment of the lumbar spine. Another third may not experience ideal realignment, but they report a more than 50 percent improvement in back and leg pain. The remaining third may find the exercise too painful and choose to discontinue.
In other words, this rehabilitation method has a success rate of more than 50 percent, making it a worthwhile option to consider before resorting to surgery.
A randomized controlled clinical trial published in the Physical Therapy & Rehabilitation Journal demonstrated that both flexion exercises and lumbar stabilization exercises can improve symptoms in patients with degenerative spondylolisthesis. After six months of consistent practice, patients experienced significant reductions in low back pain and radicular symptoms. Among the 85 patients who underwent physical therapy, only four required surgery within four years following the study.
Summary
For people dealing with lumbar spondylolisthesis, trying these simple self-rehabilitation exercises is advisable—they may even resolve the issue, sparing you the need for pain medications, surgery, and their associated risks and side effects. If you found this article helpful and know friends who may benefit from it, feel free to share it with them. Thank you for reading, and see you next time!Views expressed in this article are the opinions of the author and do not necessarily reflect the views of The Epoch Times. Epoch Health welcomes professional discussion and friendly debate. To submit an opinion piece, please follow these guidelines and submit through our form here.
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