Spinal Anomalies, Low Back Pain

The bouts of pain may occur as the individual engages in their usual employment, household chores, gardening, or when they engage in sporting activities. At times even the slightest wrong movement, such as lifting, reaching, or twisting, may bring on a bout of pain.

There can be many, many reasons for low back pain; however, we will discuss a very important reason that has not been spoken of or even usually thought of in diagnosing this condition. These are called "congenital anomalies". A congenital anomaly is something we are born with, that is not within normal limits. An anomaly can be found in any area such as, bone, muscle, ligament, tissue or organ. Very often congenital anomalies can be an inherited trait. The anomaly we are primarily focused on is found in the lower spinal column and its relation to the pain it can cause.

The lumbar area of the spine is comprised of 5 lumbar vertebrae. The 5th lumbar vertebra sits on the broad triangular bone called the "sacrum". On either side of the 5th lumbar and the sacrum are the 2 hipbones, called the"ilii". An anomaly can occur in any of the lumbar vertebrae, the sacrum, or the hipbones (ilii). There can even be one vertebrae missing, or an extra 6th lumbar vertebra, or even a half vertebra. More often anomalies or abnormalities are found in the facets of the vertebrae. The facets are the articulations that align the vertebrae with each other, keeping them fro shifting or sliding.

However, we will discuss another very prevalent anomaly that is found in the 5th lumbar vertebra. Consider this vertebra as one of a child's building blocks. On either side of the block (vertebra) are two fingerlike projections, called the "transverse processes". It is these transverse processes where the congenital anomalies occur. When an individual is born with enlarged transverse processes they will have a tendency to meet and rub against the hipbones (ilii). This can occur on either one or both sides. They can also enlarge even more over a period of years. After years of this occurrence, the transverse processes will cause a fusion with itself and the hipbone, creating a false joint, or joints. There will of course be no normal movement in these false joints.

A condition such as this can set up a myriad of circumstances, affecting the muscles, ligaments and tendons that cause a progression of symptoms and finally severe bouts of low back pain. Although the individual may not lose any motion of the low back, they may have some difficulty in bending forward or backward. After activities that require such prolonged movements, the individual may find some difficulty in getting out of bed, or getting up from a sitting position.

Should an individual find they are experiencing symptoms such as bouts of pain that are nagging, dull and vague in character, and they just can't seem put their finger on the exact spot where it is originating from, they should of course seek professional advice from their healthcare provider. The doctor will after a physical examination, take x-rays that will enable him/her to make a definitive diagnosis. After the diagnosis, they may recommend medications that will only help with some of the pain. Most individuals are already familiar with these over the counter medications OTC). Unfortunately, this condition is not correctable by conservative methods.

Once a definitive diagnosis is made, it will be up to the individual to create a plan to deal with the situation in an effort to prevent more invasive measures such as surgery. Read more on how to plan in the Health Hints below.

Health Hints***

• The individual must be mindful of his/her lower back inadequacies at all times. This means that when they engage in some activity, such as, sports, gardening, or stressful household chores such as vacuuming, ironing, etc., they should gently stretch their back muscles. It will only take one or two minutes. If you golf, hold two or three clubs and gently swing them up to one shoulder following through to the other shoulder. If you bowl, throw a few balls down the alley slowly and gently. Do the same for any other sport following the protocol of that particular sport.


• Before and after engaging in these sports or chores, you can apply a good analgesic gel.


• Should you experience a sharp pain during golfing, bowling, etc., it would be advisable to stop any further participation in that activity.


• If you do experience sharp pain after playing sports, the use of ice is advisable. An ice massage is excellent. This can be accomplished by keeping a few paper cups in the freezer filled with water and having them frozen, ready for such uses at all times. When ready to use, tear about a half-inch strip from around the top of the cup. As you massage the painful area in circular motions, keep tearing small strips from around the paper cup as the ice melts. This should be repeated 3 to 4 times daily, using the analgesic gel between the applications of the ice massage.


• After 48 hours, if the pain persists, start using applications of heat. Apply the heat in the form of a heating pad for 20-30 minutes to the painful area 3 to 4 times daily. Using a moist heat pad is more beneficial as it allows an easier, deeper penetration. Again, apply the analgesic gel between the applications of the heat.


• The above steps will help in the alleviation of the pain. However, the best way is prevention with the long-term outlook of preventing the onset of these painful episodes. To do this, you must start an exercise program that will strengthen, support and reinforce the entire low back structure. Before starting any exercise program you should discuss it with your healthcare provider. Once you have been cleared, you must find a program that you are comfortable with, and one you will stay with for the long haul.


• The next step in choosing an exercise program is choosing one that will not aggravate your condition. It also needs to strengthen the abdominal and low back muscles, ligaments and tendons that are of key importance in supporting the lower back. For this you need a non-impact exercise program.

Whatever exercise program you start on, just make sure you do no harm. Be comfortable with it. Be able to find the time to do it. AND, stay with it for the long haul. You will feel better.