Bertolotti’s Syndrome: Signs and Symptoms

Back pain can be caused by many factors, and Bertolotti’s syndrome is a commonly missed source. This condition is caused by an anomaly in the spine, which leads to discomfort that can mimic other back pain conditions. Bertolotti’s syndrome affects people differently, and there are several treatments available for addressing the various symptoms.


What Is Bertolotti’s Syndrome?


People with Bertolotti’s syndrome have a variation in their fifth lumbar vertebra called the lumbosacral transitional vertebra. Part of this bone fuses with the ilium or sacrum, generating pain and interfering with normal function.

Normally, people have a disc between the last vertebra and the sacrum, which allows for freedom of movement. However, people with Bertolotti’s syndrome have a partial disc or no disc at all. This is known as a pseudo or transitional joint.

While this condition isn’t disabling, the anomaly can cause degeneration, inflammation and deformity. As bones rub together, they cause discomfort. The resulting swelling puts pressure on the L5 nerve root, which is one of the foundations of the sciatic nerve.

Bertolotti’s syndrome can significantly affect your quality of life. The spinal misalignment can lead to muscle imbalances, arthritic conditions, disc degeneration or herniation or stenosis.

Common symptoms of Bertolotti’s syndrome include:

  • Unexplained pain in the hip, groin, lower back or sacroiliac joint
  • Sciatic nerve pain, which may radiate to the buttock, lower back or legs
  • Tilted pelvis or legs of different lengths
  • Stiffness and mobility issues
  • Pain that diminishes when you sit or lie down
  • Unilateral muscle spasms or pain


What Causes Bertolotti’s and How Is it Diagnosed?


People with Bertolotti’s syndrome are born with a fused L5 joint. This is thought to occur in about 10 to 20% of the population.

The joint fusion will show up in an X-ray. People who have no signs of Bertolotti’s symptoms might find out that they have some L5 fusion when they undergo X-rays for another issue, such as an accident.

Many people with this anomaly never present with symptoms and don’t require any intervention. However, when symptoms are present and sacralization is identified, Bertolotti’s syndrome is the diagnosis. Even though you’re born with the condition, you may not start to feel symptoms until your 20s or 30s.

To diagnose Bertolotti’s, your doctor will perform a thorough physical examination to explore the movements that cause pain and discomfort. They’ll look for pain that increases with standing up from sitting or walking. They will often conduct a straight leg raise test to evaluate the level and location of the pain. Using those indicators as well as your medical history and X-rays, they may conclude that the pseudo joint at L5 is generating your pain.

This is often a relief for patients who have searched for a cause for their back pain. An accurate diagnosis allows your doctor to develop an effective treatment plan.


What Are My Treatment Options for Bertolotti’s Syndrome?


There is a wide range of treatment options available for Bertolotti’s syndrome. At the offices of Dr. Craig Callewart, we customize our treatments to your needs.


Non-Surgical Treatments


Some of the more conservative treatments for Bertolotti’s syndrome include:

  • Lifestyle changes – Your posture, exercise regimen and repetitive motions can exacerbate symptoms of Bertolotti’s. You may need to change your routine to avoid certain positions and movement patterns.
  • Physical therapy – Specific techniques that are used to manage Bertolotti’s symptoms are lumbosacral region manipulation, mobility exercises, stretching and core strengthening exercises.
  • Over-the-counter pain relievers – Analgesics and anti-inflammatory medications can relieve some of your symptoms.
  • Epidural injections – This minimally invasive treatment involves injecting the area along the nerve with corticosteroids to reduce swelling and relieve some of the pressure on the nerve. In more severe cases, nerve root block or lidocaine injections can help you feel better.


Surgical Treatments


Lumbar fusion is one of the most common surgical treatments for Bertolotti’s. This involves fixing the bones together so that they don’t rub against the pelvis and cause pain.

A laminotomy is often used to remove a spiny arch from the vertebrae to create more space for spinal movement. For Bertolotti’s, a laminectomy, which is the complete removal of the lamina, can relieve some of the symptoms.


Put an End to Your Chronic Back Pain


It can be frustrating to deal with back pain, especially when you don’t know the source of the problem. At the offices of Dr. Craig Callewart, we can help you identify the issue and provide targeted solutions for getting you back on track. Identifying or ruling out Bertolotti’s is an essential step in the process.

Contact the offices of Dr. Callewart to get a diagnosis for mild to severe back pain. We provide comprehensive treatment and continuity of care to ensure that you get the relief that you deserve.

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