# How to Fix Back Pain from Spondylolisthesis Naturally

Source: https://www.youtube.com/watch?v=JCQpg66nf_Y
Recap page: https://rapidrecap.app/video/JCQpg66nf_Y
Generated: 2025-11-11T11:01:59.858+00:00

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## Quick Overview

The best natural treatment for back pain caused by spondylolisthesis involves consistent, conscious engagement of the lower abdominal muscles (abs) to create internal stability, which allows the slipping vertebra to reposition itself without surgical intervention like rods and screws.

**Key Points:**
- Spondylolisthesis involves a vertebra slipping forward, often at the L5 segment, which can cause pain and instability if ligaments weaken.
- The primary non-surgical treatment focuses on strengthening the lower abdominal muscles (abs) to actively pull the slipped vertebra back into place.
- Patients must learn to engage their abs consistently, holding a low-level contraction (20-25% effort, not 100%) throughout the day, especially during activities like lifting a baby.
- A case study involved a young volleyball player with chronic back pain who could not stand upright without pain due to L5 slippage, but improved significantly with this core engagement technique.
- Improper abdominal engagement, where patients stick their chest/rear out instead of sucking the abs in, worsens the spinal instability.
- Surgery involving rods and screws (fusion) is an option if the slippage causes a fracture, but learning proper core engagement offers a non-invasive, long-term solution.

![Screenshot at 00:04: Dr. David Middaugh holds a spinal model demonstrating the forward slippage of a vertebra \(spondylolisthesis\) to explain the structural problem causing the patient's back pain.](https://ss.rapidrecap.app/screens/JCQpg66nf_Y/00-00-04.png)

**Context:** The video features Dr. David Middaugh, a Manual Physical Therapist, explaining the mechanism of spondylolisthesis—a condition where a vertebra slips forward, often at the L5 level—and presenting a natural, non-surgical method for managing the resulting back pain by utilizing core strength.

## Detailed Analysis

Dr. David Middaugh explains that back pain from spondylolisthesis, where a vertebra (often L5) slips forward, results from instability due to weakened ligaments and poor core muscle function. He uses a spinal model to illustrate how the upper vertebra slides forward, potentially causing fractures or disc issues requiring surgery if left untreated with rods and screws. Middaugh emphasizes that the key to natural treatment is learning to properly engage the deep lower abdominal muscles (the area around the belly button). He describes the common mistake where people overcompensate by sticking their chest/rear out, which exacerbates the problem. The correct technique involves consciously sucking the abs in and holding a low-level (20-25%) contraction consistently throughout the day, even while resting or performing daily tasks like picking up a baby. He shares a success story of a young volleyball player who had severe pain and instability but regained function by mastering this core activation technique, proving that consistent, correct abdominal bracing can stabilize the spine and avoid invasive procedures.

### Spondylolisthesis Mechanism

- Forward slippage of the vertebra (often L5)
- Instability due to loose ligaments and weak core
- Potential for fractures requiring fusion surgery

### The Core Treatment Strategy

- Focus on strengthening the lower abdominal muscles (abs)
- Consciously suck abs in and hold a low-level contraction (20-25%)
- Consistent daily engagement stabilizes the spine and allows repositioning

### Common Mistake in Core Firing

- Sticking the chest and rear out instead of drawing the abdomen in
- This movement worsens instability and compression on the spine

### Case Study Outcome

- A young athlete with severe pain from L5 slippage regained function after learning proper core firing
- She could finally stand upright without pain and return to volleyball

### Long-Term Management

- Learn to use abs consistently throughout the day, rather than forcing 100% contraction
- Non-invasive core strength building is the best long-term fix over surgery

![Screenshot at 00:04: Dr. David Middaugh holds a spinal model to visually define spondylolisthesis as a forward slip of a vertebra.](https://ss.rapidrecap.app/screens/JCQpg66nf_Y/00-00-04.png)
![Screenshot at 00:14: A graphic overlay illustrates the L5 and L4 vertebrae, highlighting the anterior slippage characteristic of spondylolisthesis.](https://ss.rapidrecap.app/screens/JCQpg66nf_Y/00-00-14.png)
![Screenshot at 00:22: Dr. Middaugh demonstrates the forward displacement on the physical model, labeling the condition as spondylolisthesis.](https://ss.rapidrecap.app/screens/JCQpg66nf_Y/00-00-22.png)
![Screenshot at 01:55: The physical skeleton model is used to point out the location of the lower lumbar vertebrae \(L5\) and the surrounding erector muscles.](https://ss.rapidrecap.app/screens/JCQpg66nf_Y/00-01-55.png)
![Screenshot at 03:00: Dr. Middaugh demonstrates the correct core engagement by sucking his abdomen inward on the model, contrasting it with the painful position.](https://ss.rapidrecap.app/screens/JCQpg66nf_Y/00-03-00.png)
![Screenshot at 04:07: Dr. Middaugh uses his hands on his abdomen to physically demonstrate the required 'suck in' motion for core stabilization.](https://ss.rapidrecap.app/screens/JCQpg66nf_Y/00-04-07.png)
![Screenshot at 06:40: The therapist gestures toward the full skeleton model to indicate the location of the rectus abdominis muscles relative to the spine.](https://ss.rapidrecap.app/screens/JCQpg66nf_Y/00-06-40.png)
![Screenshot at 09:44: Dr. Middaugh demonstrates the incorrect technique: pushing the chest and rear out instead of drawing the abs in.](https://ss.rapidrecap.app/screens/JCQpg66nf_Y/00-09-44.png)
![Screenshot at 10:38: Dr. Middaugh holds the model again while discussing how surgical fusion permanently fixes the alignment but neglects the underlying muscle control issue.](https://ss.rapidrecap.app/screens/JCQpg66nf_Y/00-10-38.png)