Lumbar spondylolisthesis: a rational approach to conservative treatment.

Forth-seven patients with symptomatic back pain secondary to spondylolisthesis who were not surgical candidates were instructed in a treatment program that included flexion or extension or combined flexion-extension exercises. At follow-up, symptomatic changes were correlated with the type of exercise program. Patients treated with flexion-type exercises were less likely to require use of back supports, require job modification, or limit their activities because of pain. Although surgical treatment of spondylolisthesis has been outlined in current literature, conservative programs have not been well defined. Factors aggravating pain and a specific program for pain reduction are discussed.