Bertolotti syndrome is something that has not been heard of when it comes to lower back pain, but diagnostic work has uncovered a common congenital condition. Back pain is experienced at some point by all of us. Around two-thirds of the population will develop low back pain in their life, and more than half will develop chronic low back pain or pain that has lasted more than six months. Low back pain can be challenging to find the root cause. Diagnostic work is required throughΒ X-rays and MRIs. These tests identify a lesser-known cause of mechanical low back pain: BertolottiΒ syndrome.
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This congenital conditionβs name comes from Italian physician Mario Bertolotti. It is in 10 to 20 percent of the population βwith or with no lower back pain. Bertolotti syndrome happens when the lumbosacral transitional vertebra is the last lumbarΒ vertebra/LSTV. This vertebra and the sacrum become fused or create a false joint due to an enlarged transverse process.
These can be bony bumps on the vertebrae where muscles and ligaments attach to the lumbosacral transitional vertebra. When the LSTV and sacrum fuse together, known as sacralization or pseudo-joint, it does not generate pain. Itβs just how an individualβs anatomy has been since birth. Only when it causes lower back pain that is it called Bertolotti syndrome.
Low back pain that leads to inflammation and reactive muscle spasms brought on from Bertolotti syndrome can be caused by:
Most individuals usually never know they have a sacralization or pseudo-joint. These are often found accidentally from an X-ray for something unrelated. But symptoms can vary from person to person and usually appear in adulthoodβin the 20s or 30s.
Bertolotti syndrome can be diagnosed based on medical history, physical exam, and X-rays. A physical exam can include a recreation of the movement/s that triggered the pain/discomfort. An X-ray of the low back and pelvis will reveal any bony abnormalities.
Bertolotti syndrome can be effectively managed with non-invasive treatments. TheseΒ include:
If you or someone you know is dealing with some form of idiopathic low back pain and doctors canβt seem to pinpoint the cause. Bertolotti syndrome could be a suspect; therefore, itβs best to seek a spine specialist near you that can help.
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The information herein on "Bertolotti Syndrome An Unusual Suspect in Low Back Pain" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.
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Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*
email: coach@elpasofunctionalmedicine.com
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Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
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