When to worry about lower back pain with spondylolisthesis

Spondylolisthesis occurs when one vertebra shifts in relation to another. The movement can irritate nearby joints, discs, or nerves. Pain may stay in the lower back, spread into the buttock or leg, or increase with standing, walking, bending, or lifting. New tingling, reduced sensation, or weakness can suggest nerve involvement and deserves clinical attention.

Arrange an assessment if pain keeps returning, is becoming more intense, or is interfering with sleep, work, exercise, or walking. Until you are assessed, change position regularly, avoid movements that sharply increase symptoms, and use only pain medicines that are suitable for you. A clinician may check strength, sensation, reflexes, movement, and walking before deciding whether imaging or physiotherapy is useful.

Seek urgent medical help for new or worsening leg weakness, numbness around the inner thighs or genitals, difficulty starting or controlling urination, loss of bowel control, or severe pain after an injury. Fever, feeling very unwell, or unexplained weight loss alongside back pain also warrants prompt medical review. Do not wait for a routine appointment when nerve or bladder symptoms appear.

Ask whether your symptoms suggest nerve irritation, which activities are safe while pain settles, and whether you need a neurological examination or imaging. You can also ask how to recognise a change that should be reported immediately and which exercises can support your back without aggravating symptoms.