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sacralization of L5
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Mid-Back & Lower-Back Pain Questions

TOPIC: sacralization of L5

sacralization of L5 2 years, 6 months ago #1360

Hello my name is Jamie. I am female 25 years old. I have had lower right back pain for 2 years now. My most recent MRI showed a transitional vertebra at L5 and partial sacralization of L5. I have been treated at the pain clinc for 1.5 years. They have been treating me for SI joint pain. They diagnosed me with sacroiliitis. I have had no known injury to my SI joint and they seem unable to determine why I would have SI joint pain. I honestly don't think that is where my pain is coming from. The pain is above the sacrum on the right side. It feels like something is constantly stabbing my right hip and the pain radiates down my right leg along the lateral side down to my ankle. I am a nurse and have had to go out of work because of this pain. When I get an SI injection it doesn't help. I have had 4. I don't understand why they are telling my that is where my pain is coming from. Is it possible the pain is coming from this abnormal vertebra and abnormal wear on this joint? The MRI report said mild osteoarthritis and the sacralization of L5. Aparently the bones have rubbed together enough to sacralize. The MRI I had done in 2010 did not show sacralization of L5. The pain clinic has refered me to an orthopedic surgeon for SI joint surgery to fuse that joint. I am not convenced that is my problem. I don't want to have this major surgery if it is not the problem. Is it possible my pain is coming from L5-S1 and if so is there a surgery to correct this? I have tried PT with no success. Thank you for your help in advance. The pain clinic keeps telling me that sacralization of L5 is not an abnormal finding and it does not cause pain.

Jamie
Last Edit: 2 years, 6 months ago by Dr. Corenman.

Re: sacralization of L5 2 years, 6 months ago #1363

The origin of SI pain is very rarely the SI joint. If you have had SI blocks without 2-3 hours or temporary relief immediately after the injection, the SI joint is not the cause of your pain. Typically, SI joint pain originates from the disc or nerve root at L4-5 or L5-S1. I have however seen three cases of pain originating from the transverse-alar articulation at L5-S1.

This articulation is also known as sacralization of the L5-S1 level. What this structure really is turns out to be an enlarged transverse process of L5 that creates a new joint with the ala of the sacrum on that side (hence: tranverse-alar articulation).

To discover the source of your pain, you need diagnostic blocks of all of the potential pain provoking structures. You need to keep a pain diary (see section on pain diary on the website). Once the suspect structure is anesthetized and is the obvious source of pain, then if needed, a surgical plan can be established.

Dr. Corenman
Dr. Corenman

This answer is for educational purposes only and is not a substitute for a diagnosis from a qualified professional. Do not try to diagnose or treat yourself based solely upon reading this material.

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Re: sacralization of L5 2 years, 6 months ago #1364

Ok thank you so much for your time and help! I can't get my doctors to even listen to me. You have been a great help and now I know where to go from here. I certainly didn't want a major surgery that I don't need. Thank you again!

Jamie Lake

Re: sacralization of L5 1 year, 10 months ago #2849

I too have sacralazation/lumbarization. I began to have chronic pain in my pelvis and supra pubic region 16 months ago. It is still undiagnosed but after months of PT on my pelvis and hips, my sacrum is now inflamed. I have had injections in L5 S1 which helped the sacral pain and a transverse alar injection. Neither changed the pelvic pain.

It's been 4 months since the L5 S1. And my sacrum keeps me from leaning back in a chair or car seat. Should I have a series of injections. Have been trying yoga to open the area, but not much relief.

The real question is. Can the impingement in my back cause the pelvic and groin pain?

Thank you so much

Re: sacralization of L5 1 year, 10 months ago #2853

Even though I have seen three case of painful transverse-alar articulation pain, the vast majority of these articulations are not painful. Suprapubic pain generally is not related to the spine. Some individuals can have hip impingement syndromes which can induce these type of symptoms. A visit to a hip specialist and MRI and an intraarticular injection that yields temporary relief can diagnose this disorder.

L5-S1 injections that help the sacral pain could indicate radiculopathy, degenerative disc disease or even facet syndrome. The injections have to be specifically placed to diagnose which disorder is causing the sacral pain.

Dr. Corenman
Dr. Corenman

This answer is for educational purposes only and is not a substitute for a diagnosis from a qualified professional. Do not try to diagnose or treat yourself based solely upon reading this material.

back pain forum • lower back pain forum • spine surgery forum • neck pain forum

Re: sacralization of L5 1 year, 10 months ago #2859

Thank you for your reply.. I also have degeneration of L3 & 4. Speculation is that the connection to the psoas may be shortened thereby causing the torque on my right hip

Any activity - standing, walking, swimming increases my pain. Sitting is impossible. I cannot exercise at this time nor even take a short stroll.

I am truly desperate for a diagnosis and proposal for solution.
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