Sacralization of L5 CaseFile

LOWER BACK PAIN

Mrs D, a 39-year old woman first consulted me two years ago. Over the previous three years she had three severe, acute attacks of lower back pain, without referral to the legs. Whilst the acute phase passed, she continued to have nagging backache every day.

Her mother and sister also have episodic lower back pain. This is a strongly hereditary condition.

What finally prompted her to consult a chiropractor was two episodes, one six weeks and the second a week before her first consult. Despite physiotherapeutic treatments spanning every week for a whole year, and an orthopaedic consult, the condition was clearly going downhil. Sneezing caused extreme pain in the small of the back.

SACRALIZATION and LUMBARISATION

They are but two sides of the same coin.

Skullduggery! The search engines have no interest in the word "lumbarisation" so I've called this page 'Sacralization of L5' but in fact this Sacralization of L5 CaseFile is a lumbarisation! Six vertebrae instead of five.

X-rays

On examination

Forward bending was strongly painful in the low back. Extension and sideways bending to the left was mildly painful in the left sacro-iliac joint, and at L5.

On motion palpation, L5 was strongly fixated (due in part to the lumbarisation / sacralisation of the lower-most vertebra, which is usually L5.) There was no sacro-iliac fixation. Surprising, as it usually gets tight along with L5.

On orthopedic testing, the Slump test was positive, raising the left leg provoked right lower back pain. All four sacroiliac joint anatomy tests were positive on the right. Yet no SI fixation on motion palpation. Odd!

SACROILIAC JOINT ANATOMY ...

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HEEL LIFT for the short leg

LEG LENGTH INEQUALITY ...

LEG LENGTH INEQUALITY and Low Back Pain ...

PROGRESS

However she went faithfully through the rehabilitation protocol, another 4-5 treatments, making it 12 in total. She also had some neck pain.

She had one slight setback about three months later, which passed with one of the 'control' treatments. That was eighteen months ago. Since then she has had no pain at all.

Mrs D wears her heel-lift faithfully, does her exercises with passion and enthusiasm (they only last one and a half minutes every morning and every evening in bed, before arising and taking to dream-land, and comes every ten weeks for a 'control' treatment, as we call it in the Netherlands.

She reported this morning that she has had absolutely no problems. Long may it continue!

DISCUSSION of Sacralization of L5 CaseFile

It is often associated with other anomolies, in Mrs D's case a short leg, and a pronated foot.

Addressing all the above is what brings success in the treatment of lower back pain - the foot (a subluxated cuboid bone), the short leg (a heel lift) and the pelvis in this case. I still haven't adjusted her lumbar spine. The problem was in the pelvis, and oddly with no fixation in the sacro-iliac joint.

Each back brings its surprises, and oddities. Hence the challenge to your Chiropractor. Can s/he puzzle it out? With your honest feedback and positive contribution, I'm sure!

Have A Question about your lower back?

I receive many questions about Chiropractic. It might be help with a spinal condition, but it might also be from a person who can't walk after a hip operation, or some such thing.

I will do that by answering your questions personally, but it will be converted to a Web Page so others can benefit from your questions. Omit your name if you like...

However, do understand that, in the main, I'm going to be directing you (should it be pertinent) to a Chiropractor in your neck of the woods. I'll respond to all reasonable inquiries, but please be specific, and give some details.

There is no charge for this service, however if you find my answer useful, you might like to consider purchasing my latest book, Stones in my Clog. Gems, both funny and healthful, from the life and work of a Chiropractor. It's only $2.99. (http://www.bernard-preston.com/Stones-in-my-Clog.html)

Pose Me A Question! Pretty please, in decent grammar and spelling.

I will never give or sell your e-mail address to anyone.

Do understand that lower back pain is extremely complex, so I can only give general guidelines. There's no substitute for a careful thorough chiropractic examination.

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