Diagnosis Explanation:

Spondylolisthesis occurs when one vertebra slips forward over the one below it, usually in the lower back (lumbar spine). It can result from stress fractures, aging, degenerative disc disease, or congenital defects. Symptoms range from mild low back pain to radiating leg pain (sciatica), stiffness, muscle spasms, and difficulty standing or walking for long periods.

Specific Work Modifications:

• If your job requires standing or walking: Use supportive footwear, maintain a neutral spine, and take frequent seated breaks.
• If your job involves lifting: Avoid heavy lifting, bending, and twisting. Use proper lifting techniques and consider wearing a lumbar brace if necessary.
• If your job is desk-based: Use an ergonomic chair with lumbar support, keep feet flat on the floor, and take standing breaks every 30-60 minutes.
• Avoid: Prolonged sitting or standing, repetitive bending, heavy lifting, and twisting motions.

Specific Activity Modifications:

• If you run or play sports: Reduce high-impact activities and switch to swimming, cycling, or walking on soft surfaces.
• If you hike: Use trekking poles, avoid steep inclines, and limit backpack weight.
• If you do weightlifting: Avoid deadlifts, heavy squats, and overhead presses; focus on core stability exercises.
• Avoid: High-impact activities, excessive bending backward (hyperextension), and twisting.

Recommended Supplements:

• Collagen Peptides – 10g daily to support discs and ligaments.
• Calcium & Vitamin D3 – 1000mg/800 IU daily for bone strength.
• Magnesium – 300-400mg daily to relax muscles and prevent spasms.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Turmeric (Curcumin) – 500-1000mg daily for pain relief.

Recommended Nutrition and Hydration:

• Eat Anti-Inflammatory Foods (salmon, leafy greens, turmeric, berries, nuts) to reduce pain and stiffness.
• Increase Lean Protein (chicken, fish, tofu, eggs) to support muscle and ligament healing.
• Consume Hydrating Foods (cucumber, watermelon, citrus) to maintain tissue hydration.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to keep spinal discs hydrated.

Home Exercise Prescription (Rehabilitation for Spondylolisthesis)

Early Phase (0-2 Weeks, Reducing Pain & Stabilizing the Spine):

• Pelvic Tilts – Lie on your back, flatten your lower back against the floor, hold 5 seconds, repeat 10 reps, 2x/day.
• Cat-Cow Stretch – On hands and knees, arch and round your back, repeat 10 reps, 2x/day.
• Child’s Pose – Sit back onto heels, stretch arms forward, hold 20 seconds, 3x/day.
• Standing Back Extensions – Hands on lower back, gently lean backward, hold 5 seconds, repeat 10 reps, 2x/day.

Strengthening Phase (2-6 Weeks, Improving Core & Hip Stability):

• Glute Bridges – Lie on your back, lift hips while engaging the core, 10 reps, 2x/day.
• Bird Dog Exercise – On hands and knees, extend opposite arm and leg, hold 5 seconds, repeat 10 reps, 2x/day.
• Seated Rows (Resistance Band) – Pull band toward chest while keeping back straight, 10 reps, 2x/day.

Advanced Phase (6+ Weeks, Preventing Recurrence & Enhancing Stability):

• Side Planks (Modified if Needed) – Hold for 10-20 seconds, increase gradually.
• Standing Hamstring Stretch – Place foot on an elevated surface, lean forward slightly, hold 20 seconds, 3x/day.
• Stationary Cycling or Swimming – 15-20 minutes/day for low-impact strengthening.

Helpful Books:

1. Treat Your Own Back – Robin McKenzie (self-treatment techniques for spinal health).
2. The Spondylolisthesis Handbook: A Guide for Patients, Caregivers, and Practitioners – Joanne Broatch.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.