Lumbar Spine & Pelvis Conditions: Causes, Symptoms & Treatment

Lumbar Spine & Pelvis

Sacralization

L5 becomes fused to the sacrum (essentially only 4 lumbar vertebrae; usually asymptomatic). Movement is only available in the 4 lumbar vertebrae.

Lumbarization

S1 fails to unite with the remainder of the sacrum (like a 6th lumbar vertebra; common in ~10% of the population).

Lordosis

Exaggerated curvature in the lumbar spine (butt out, chest out, anterior pelvic tilt).

Kyphosis

Exaggerated curvature in the thoracic spine (has forward head so that you aren’t looking down at the ground all the time).

Scoliosis

Lateral curvature of the spine

• C-shape: thoracic spine
• S-shape: lumbar spine; may compensate for curvature in thoracic spine to remain upright.

Low Back Muscle Strain

Stretch or tear in one or more of the paraspinal muscles or tendons

• Acute strain: sudden extension contraction on an overloaded or underdeveloped spine, usually in combination with trunk rotation
• Chronic strain: faulty posture that involves excessive lumbar lordosis, flat back, or scoliosis. Shortened back muscles create chronic strain.

Lumbar Sprain

Stretch or tear in any of the ligaments of the lumbar spine; most commonly involves lumbar facet joints. Forward bending and twisting while lifting or moving an object; “lifting with the back”. Traumatic force overextends the spinal joints—can be due to a single incident or repetitive stress.

Lumbar Vertebrae Fracture/Dislocation

Compression fracture of the body or fracture of the spinous or transverse process. Dislocations of the facet joints are rare and occur only with an associated fracture. Compression fractures are usually the result of trunk hyperflexion or falling from a height.

Intervertebral Disc Herniation

Degeneration, tears, and cracks in the annulus fibrosis of the disc. Nucleus pulposus protrudes into or through the annulus fibrosis.

Lumbar Herniated Disc

Etiology—caused by abnormal stresses and degeneration due to use (forward bending and twisting).

Spinal Stenosis

Narrowing of the spinal canal or intervertebral foramen (compresses contents within the canal). Common in 50- to 60-year-olds.

S&S: pain during walking, numbness or tingling, weakness, radiating pain.

Sciatica

Nerve root compression of the sciatic nerve (sciatic nerve = tibial + common peroneal nerve). Inflammatory condition of the sciatic nerve (aka piriformis syndrome).

Typical causes—intervertebral disc protrusion, structural irregularities within the intervertebral foramina, tightness in the piriformis, torsion or direct blow to the sciatic nerve as it emerges from the spine.