From Dr. Natalie Meiri’s Clinical Pearl Stories: Chiropractor West Palm Beach: From Lifting Injury to Bertolotti’s Syndrome
This was a 40 year old male patient with a chief complaint of thoracolumbar (junction of mid and low back) pain. To be HIPAA compliant, I will call him Todd instead of his real name. Todd had been coming to see me for close to 3 years on and off for back pain.
This year, he had another injury to the same area as the last few times. He worked in a warehouse for a shipping company. Todd spent most of his day lifting heavy boxes. He also worked out at the gym. He could barely turn his torso or flex forward when he presented to my office.
Todd’s Examination for his Back Pain
Upon examination, I found positive tests for a lumbar (low back) sprain with thoracic (midback) myalgia (muscle pain) diagnoses. Also, a test showed that his neck was problematic. Todd described the neck as “stiff” but not painful as his thoracolumbar spine felt.
I ordered x-rays of Todd’s cervical, thoracic and lumbar spine. Upon review, Todd’s x-rays revealed sacralization in his low back xray. Additionally, Todd’s cervical
x-ray showed he had a loss of lordosis. So a loss of lordosis refers to a natural inward curve of the spine is lost. In other words, the curve straightens out. This is due to bad posture, injury, osteoarthritis (wear and tear arthritis), or a congenital condition. Todd’s spine also showed moderate osteoarthritis throughtout,
What is Sacralization?
Sacralization affects roughly 4% to 10% of the population. Sacralization is a spinal congenital (born with) anomaly. And the lowest lumbar vertebra (usually L5) completely or partially fuses with the sacrum. Also, it is called a type of lumbosacral transitional vertebrae. Because the condition decreases normal mobility, it causes spinal stress. Lastly, when sacralization causes chronic lower back pain, it is called Bertolotii Syndrome.
The types of sacralization are various: Types range from unilateral (one sided), bilateral (both sided), fully fused and a pseudoarthrosis (false) joint.urthermore, diagnosis is confirmed only through imaging (x-ray, MRI).
Todd’s Treatment
Firstly, Todd received chiropractic adjustments to his spine. Next, soft tissue manipulation to his spasmed muscles. Subsequently, Therapeutic exercises was incorporated for development of endurance, range of motion/flexibility, and strengthening.
Secondly, I recommended acupuncture after the 5th visit to enhance his recovery from his spasmed muscles and inflamed joints.
Thirdly, while chiropractic and/or acupuncture cannot physically unfuse or restructure the bones, it targets the secondary problems caused by the sacralization. For example, the muscles around his hips and lower back (quadratus lumborum and gluteal muscles) were compensating. These muscles were hypertonic due to the impact of the uneven spine. Both chiropractic and acupuncture reduce inflammation. Moreover, chiropractic normalizes function to the joints. And acupuncture stimulates the nervous system to release endorphins (natural opioids).
Todd’s Outcome to Treatment
Todd responded well to his treatments. In fact, by the 7th visit his pain had decreased to 50%. And his full range of motion was back. After 12 visits, Todd was able to return to his gym activities. Importantly, he was mostly pain-free. Finally, Todd continued care with me for supportive care and exacerbations with me as needed.
Unfortunately, there is no “cure” for Bertolotti syndrome. This is because it is caused by an inherited spinal variation. It occurs with the lowest vertebra fusing with the pelvis during fetal development. However, symptoms can be successfully managed. Also, further injury, degeneration and dysfunction can be prevented.
Chiropractor West Palm Beach: From Lifting Injury to Bertolotti’s Syndrome
Meiri Chiropractic serving West Palm Beach and the surrounding areas offers excellent chiropractic and acupuncture treatments for back pain. Call us in West Palm Beach at 561-253-8984. Schedule an appointment or to find out more about Chiropractor West Palm Beach: From Lifting Injury to Bertolotti’s Syndrome.