Hi, thanks for writing to HCM. The initial management of Spondylolisthesis is always conservative by the following measures - - Avoid excessive forward bending activities as it will worsen the disc protrusion as well as further forward slipping of the vertebra. if you want to bend forwards, do it with your hips and knees flexed. - Avoid lifting heavy weights as it imparts more strain on your back - Maintain optimum body weight,if you are obese. A faster progression of listhesis and higher chances of worsening are very common in obese individuals. - Use a lumbosacral back support to stabilize your spinal muscles and prevent further progression of the listhesis. - Use analgesic and muscle relaxants as needed. If you fail to improve with the above measures or if your symptoms are worsening in due course of time, then you may needed a surgical fixation. Hope this information is helpful. Good day