Column How to Sleep Comfortably When You’ve Been Diagnosed with Spondylolysis and Spondylolisthesis?
July 23, 2025
Spondylolysis and spondylolisthesis are conditions in which the bones of the spine crack and become misaligned after having been subjected to repeated stress caused by sports or other intensive activities during one’s teenage years.
In this article, we will explain how to sleep when you have spondylolysis or spondylolisthesis.
What are spondylolysis and spondylolisthesis?
Lumbar spondylolysis is a condition in which stress is concentrated in the posterior portion of the lumbar spine, causing fatigue fractures that result in separation of the bones. It is reported to occur more frequently in the 5th lumbar vertebra.
If lumbar spondylolysis is detected within a short period of time after the injury, the rate of bony fusion (or the probability for the separated part to heal naturally) will be higher.
On the other hand, the longer it takes to detect the condition, the more probable it is that the bone fusion will be insufficient, and a condition called pseudoarthrosis (a bone fracture that is unstable) may develop. When pseudoarthrosis (or nonunion) occurs, the bone will shift forward around the separated area, resulting in lumbar spondylolysis and spondylolisthesis.
Symptoms of spondylolysis and Spondylolisthesis
The main symptom of spondylolysis and spondylolisthesis is back pain.
Low back pain that appears momentarily during exercise or when the lower back is shifted backward is characteristic of the immediate aftermath of a spondylolysis injury. It is also characterized by pain limited to a narrow area, which may be felt after playing sports.
When pseudoarthrosis occurs, bony spurs tend to develop around the area and may come in contact with the nerves. In this case, symptoms such as leg pain may occur.
When spondylolisthesis occurs, in addition to back pain, the spinal cord and nerves may be compressed, resulting in numbness.
Causes of spondylolysis and spondylolisthesis
Causes of spondylolysis and spondylolisthesis include decreased hip flexibility, decreased hip muscle strength, repetitive bending at the hip and twisting movements, and repetitive movements such as landing from a jump.
Sports played in one’s youth such as soccer, track and field, baseball, basketball, and volleyball are one of the most common causes of lower back pain.
How to sleep when you have spondylolysis and spondylolisthesis
Spondylolysis and spondylolisthesis occur when continuous stress on the lower back cause fatigue fractures, so the most important thing to keep in mind when sleeping is not to put stress on this area.
For patients sleeping on their back
Place a cushion or a hard pillow under your knees and sleep with your knees in an upright position to reduce the strain on your lower back. In this way, the pelvis will not retract and there will be no gap between the lower back and the futon/mattress, making it a little more comfortable for sleeping.
For patients sleeping on their side
Rounding the hips slightly and placing a cushion between the knees will reduce the strain on the lower back.
Sleeping positions to avoid
Sleeping on your back with legs stretched out will retract your pelvis, putting more strain on your lower back and aggravating symptoms.
Sleeping on your stomach is also very stressful on the lower back and neck and should be avoided.
If you have ever been diagnosed with spondylolysis or spondylolisthesis, please consider a consultation at one of our clinics.
