Expert: Dr. Victor Dolan, DC, DACBSP - 12/7/2009

Question
I am a runner, but my back is keeping me from achieving my full potential. What do you recommend I do? My trainer has no idea, and I believe that it is sacralization of the 5th lumbar. I would really like to run this season but, I feel my back would keep me on the IR the whole season. Please give me some advice on what to do, thank you Doc.

Answer
Back Pain, Back Problem, Low Back Pain, Athletic Potential, Performance Improvement, Staten Island Low Back Pain, Sacralization, Injured Reserve,



Hello James Clark,

I am sorry to hear of your Lower Back Pain ( I assume LBP --low back pain-- since we are talking sacralization ).

Sacralization of the 5th lumbar, lumbarization of the 1st sacral segment; these are fairly common idiosyncrasies, fairly common peculiarities of our human spine.  I, myself, have an abnormality known as Spina Bifida Occulta (SBO)- which is another fairly common peculiarity.

Sacralization:  anomalous fusion of the last lumbar vertebra with the first segment of the sacrum.  Saunders Comprehensive Dictionary, 3 ed. © 2007 Elsevier, Inc. All rights reserved  http://medical-dictionary.thefreedictionary.com/sacralization

Sacralization- medical approach:  http://www.dailystrength.org/c/Back_Pain/forum/1422338-partial-sacralization-any...

I agree: "....Sacralization is considered an anatomic variant of spinal development...therefore this is not a pathology but rather a congenital defect of spinal formation.  I see this often in my practice...it is a very common finding....."  http://en.allexperts.com/q/Chiropractors-965/2009/6/Sacralization-L5-S1.htm

Conservative approach recommended:  "....I wish the people that had" my best interest at heart" Would have invested some time in me and helped me out. Actually I don't think I even asked for help...But I want to make sure that doesn't happen to you,OK?. 6 weeks in traction....VS....a lifetime of pain even after the surgery ? take the traction....."  http://answers.yahoo.com/question/index?qid=20080704072719AAI9ASI

Sacralization is a birth defect.  Sacralization is not a disease.  Many people have sacralization or lumbarization without any symptoms, without any pain.

Your back is bio-mechanically different from other people.  This biomechanical difference may PREDISPOSE you to develop pain/ dysfunction; BUT sacralization or lumbarization (or my SBO) are not painful in and of themselves.

If you work-out / train, compete: you need to follow strict form.  You may find certain postures, certain movements do hurt you in your lower back.
But,
Sacralization should not preclude athletic activity or competition.

"....Sacralization, and the presence of lumbosacral transitional vertebrae are anomalies in which an increased incidence of backache have been established in some reports, while other studies have revealed no apparent association....." http://www.aanos.org/spinabifida&backache.html

I am sure your certified athletic trainer (ATC) has recommended that you visit the local Doctor of Chiropractic.  You could look for a local Doctor who is also additionally credentialed: DACBSP= Diplomate, American Chiropractic Board of Sport Physicians (see:  http://acbsp.com/ ).
              Many lay people do not realize that Chiropractic Doctors (DCs) have additional specialties- similar to Doctors of Medicine (MDs), see: http://www.acatoday.org/pdf/ApprovedChiropracticSpecialtyPrograms.pdf
              I would recommend a Doctor with additional sports injury, rehab or orthopedic credentials, as outlined by the American Chiropractic Association above.

Your diagnosis of "Sacralization" does not have to mean the end of your athletic participation.
Some people function absolutely fine, some people have minimal pain, some people have severe symptoms with your diagnosis.

Certain postures, certain positions in different sports may be less desirable; i.e.; a down lineman in football would probably be contraindicated, while an up linebacker, running back, safety would be less problematical.  Prolonged flexion or extension of the low back could be a problem.
              Running track, depending upon the event(s) could be problem free, or irritating to your condition.  Hurdles could cause a problem, whereas a sprint or even distance could be less of a problem.

I have worked with athletes for my entire Chiropractic career- having attained CCSP and DACBSP status.  Your condition and complaints are not uncommon to the Doctor of Chiropractic.  I recommend you see the DC who handles sports in your area.

With or without your complaint, World Class Competitors, professionals utilize chiropractic.
Of course I treat Staten Island Low Back Pain patients, but I also treat competitive athletes who are looking to prevent problems, improve performance and enhance rehabilitation.  Here is an informative handout sheet I utilize in my Staten Island Chiropractic office:





Athletic  Performance  Improvement,  Accelerated  Recovery


Chiropractic is well known to improve athletic performance, prevent sport injury, and accelerate recovery from injury or hard training.  With Doctors of Chiropractic serving on almost every nation’s Olympic Team, with Chiropractic holding official status with the USOC and serving almost every US Olympic Athlete:  the results of chiropractic cannot be  denied.     Coaches  and  athletes  are  aware  of  terms  such  as
                                
    enhanced  performance,     performance  improvement,                         .
    accelerated  recovery,   restoration   and   regeneration.                             .

Many coaching conferences   discuss   strategies   on   these   aspects   of   exercise,   competition,   sports  and  athleticism.


An interesting study was performed and published way back in 1991.   The January 1991 issue  of  the  Journal  of  Chiropractic  Research  and  Clinical  Investigation  published findings that  demonstrate  significant  increases  in  athletic  performance after  a  twelve  week  program  of  Chiropractic  treatment.  
  

Athletic  Ability  Research:

Male and female athletes between the ages of 18 and 42, representing a variety of sports backgrounds, were recruited to participate in this study. None had ever before been under chiropractic care.  Each of these participants underwent eleven separate tests, each test designed to measure a specific aspect of athletic performance. Then, half the participants were evaluated through chiropractic analysis and placed on a twelve week program of chiropractic  treatment   ( consistent regimen of chiropractic, similar to a consistent regimen of physical athletic training/ exercise ).  ( measured aspects: side step test, dodging run, right boomerang run, modified bass tests of dynamic balance, vertical power jump, standing broad jump, distance perception jump, horizontal linear space test, nelson hand reaction test, nelson speed of movement test, nelson choice of response-movement test )

All subjects continued to train and practice as usual in their sports.    At the half-way point of six weeks, they were all reevaluated and changes in scores for each group were compared.   All increases in performances by each group were measured by the average percent  of  change  in  all  eleven  tests  combined.

The control group,  those  not  receiving  chiropractic care, showed slight improvement in  eight  of  eleven  tests  ( this group had been training ‘as usual’ for the time period ).    By combining the average percentages of change on each test it was found that the control  group  showed  an  overall  improvement  of  4.5%.

Those  receiving  chiropractic  treatment   (along with their ‘usual training’),  the  test group, had dramatically different results. They showed improvement on all eleven tests for a total   10.7%  average  increase  after  six  weeks.    And  when  retested again  after  the  second  six  week  period  of  care  this  test  group  demonstrated  a remarkable      16.7%    average   increase   in   athletic   ability.
(  consider  that  one/ onehundredth of a second  ( 1/100th ) is the difference between win – lose,,, 16.7%  is HUGE )


What Do Chiropractors Do?

Chiropractors analyze the structure of the body, looking for misalignments, primarily in the spine, and also the extremities.    Spinal misalignments,   termed      vertebral subluxations,     irritate   the  nerves  which  in  turn  inhibits  the  body’s  ability to function optimally.     Like a high performance automobile,  the human structure must be balanced and in alignment to be at it’s best.    A Ferrari with pistons that don’t fire in sequence,  wheels that are out of balance or alignment,  and high performance specifications  that  are  improperly  set   will   not   only   have   it’s   performance compromised    but  will  also  have  dramatically  increased  potential  for  parts  to  wear  out  and  breakdown.   The  human  body, far more delicate and complicated than even the most advanced automobile is similar.    If  the framework,  particularly the spine,  isn’t properly aligned and balanced-  the body cannot perform  to it’s  potential and is more susceptible to illness and injury,  with  slower  recovery  when  injury does  occur.


What Do Vertebral Subluxations Do?

Vertebral subluxations cause nerve conduction interference.  This inhibits millions of messages from the brain from flowing smoothly along the nerves and in this in turn interferes with the coordination of the actions of the body.  The only health care provider trained to diagnose and correct vertebral subluxations is the Doctor of Chiropractic.  Like a properly tuned Ferrari,  the chiropractic patient athlete,  when properly aligned, functions at a level of peak performance.


Famous Athletes Utilize Chiropractics.

Many athletes have discovered the relationship between proper spinal  alignment and their own level of achievement. San Francisco Forty-Niner Greats Joe Montana and Roger Craig as well as heavy weight champion Evander Holyfield are examples of  professional and world-class athletes who realize(d)  the value of proper structural alignment and balance in their bodies.   They have learned through their own experiences what  research  has  shown;   that  through  chiropractic  care -  one  can demonstrate faster reaction time,  better balance,  improved coordination, increased muscular power;  and when injured-  accelerated recovery and regeneration.


The Competitive Edge.

Emphasis on athletic excellence continues to escalate in this country in terms of both dollars and extremes in personal sacrifice. Though the dangers of taking anabolic steroids have been widely publicized for years, the number of athletes who suffer serious health problems caused steroids continues to grow.  Now, however, the athlete looking for the competitive edge  need not look beyond the framework of  his(her)  own body.  Increased  public  awareness  is  leading  many  to  realize  that  a  natural  method  is  available  in achieving  performance  enhancement.     The  method  is  Chiropractic!

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine



Another reason I recommend the Doctor of Chiropractic ( 'the back expert') and conservative, noninvasive, safe care is the following statistics about treating pain, treating the spine:

Another information handout for my Staten Island Back Pain patients--



Safety  Issues

Are  you  aware  of  the  SAFETY  issues  relevant  to  different  health  approaches / treatments?   Here is  some   PUBLIC  published  information  that  may  interest  you:

Pain  Killing  medication???  =    16,000  deaths   ( probably  under-reported )
                         DEATH ! ? ! ?    better   watch  out  on  those  medications!!!  
SIXTEEN THOUSAND DEATHS: "Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective medications for the treatment of many chronically painful medical conditions. However, it is estimated that 25% of all serious adverse drug reactions involve NSAIDs, with more than 100,000 hospitalizations and 16,000 deaths occurring annually due to NSAID-induced gastrointestinal (GI) events."----- http://hhc.sagepub.com/cgi/content/abstract/13/6/468   Home Health Care Management & Practice, Vol. 13, No. 6, 468-475 (2001)  Motrin, Advil = NSAIDS
              Label changes ORDERED by FDA;  the FDA announced proposed label changes for OTC over-the-counter pain relievers to  include the potential for stomach bleeding and liver damage (FDA news  206- 207;  12-9-06)
              The  American Heart Association issued a scientific statement   recommending medical doctors change the way they prescribe OTC pain relievers from a first choice    to an alternate of recommending non-pharmacologic treatment (AHA statement  2-26-07).
              NSAID Acceleration of ARTHRITIS; an important side effect of Aspirin and other NSAIDS is that it will inhibit cartilage repair and accelerate cartilage  destruction ( Journal of Rheumatology, 1982; 9: 3- 5 ).   Many times people take NSAIDS  for  the pain of Arthritis,  not realizing these drugs may make the underlying condition worse.   These medications  cover  up  the  pain,  and  cause  the  problem  to   worsen.

The  above  information  must  also  be  viewed  in  the  light  that  these  ADVERSE  morbidity/ mortality  statistics  are  in  all  likelihood--- UNDER-reported!   Please see this research:

"Death by Medicine"    is  an  eye-opening  paper  published  as  a  Web  exclusive  in the March 2004 issue of Life Extension, a monthly magazine dedicated to "up-to-date coverage of the latest scientific and medical breakthroughs from around the world." As the grim title suggests, the paper explores the hazards of conventional medicine in the United States, analyzing and combining the complete published literature to date regarding injuries and deaths attributable to medicine.

  In their introduction, the authors note: "Never before have the complete statistics on the multiple causes of iatrogenesis been combined in one paper. Medical science amasses tens of thousands of papers annually - each one a tiny fragment of the whole picture. ... Each specialty, each division of medicine, keeps their own records and data on morbidity and mortality like pieces of a puzzle. But the numbers and statistics were always hiding in plain sight. We have now completed the painstaking work of reviewing thousands and thousands of studies. Finally putting the puzzle together, we came up with some disturbing answers."

The "disturbing answers" the five researchers uncover are an indictment of the entire American medical system:
         *   "The total number of deaths caused  by
         conventional medicine is an astounding
             783,936 per year**."  (  **caused by medicine  )
         * "The number of people having in hospital, adverse drug reactions (ADR) to
                   prescribed medicine is 2.2 million."
•   "Richard Besser, of the CDC, in 1995, said the number of unnecessary antibiotics
          prescribed annually for viral infections was 20 million. Dr. Besser, in 2003, now
refers to tens of millions . of unnecessary antibiotics."
"The number of unnecessary medical and surgical procedures performed
                 Annually    is 7.5 million."
         * "The number of people exposed to unnecessary hospitalization annually is 8.9 million."
         * "It is evident that the American medical system is the   leading cause of death and
injury   in the United States."

The authors are especially concerned that "(a)s few as 5% and only up to 20% of iatrogenic acts are ever reported."  (It must be noted that these reports on MEDICAL failure are compiled by MEDICAL personnel, and therefore these statistics a probably BIASED in favor of medicine, with poor outcomes being omitted or dismissed from the research.  The statistics are probably LOWER than the reality.)

They also project that the costs associated with deaths caused by medical interventions total approximately $282 billion per year, and estimate that the costs for unnecessary hospitalization and medical procedures total $16.4 billion per year.
As if this information isn't startling enough, the paper goes on to review the drug industry world. The authors discuss the dangers of many types of drugs and how their overuse is affecting our health and our environment, Next, they discuss the dangers of surgical procedures, the lack of error reporting and unnecessary hospitalization. The paper concludes with a discussion of how women are mistreated by medicine, and the dangers awaiting the unsuspecting elderly: "A total of 20% of all deaths from all causes occur in nursing homes."
The complete text of "Death by Medicine"  was   found online at www.lef.org/magazine/mag2004/" mar2004_awsi_death_01.html.    (as  of  2006)
More than 150 references and an extensive appendix support the discussions and conclusions presented in this paper. While many will find it quite disturbing, every health care provider and every patient should read this paper.
Reference
1).  Gary Null, PhD,  Carolyn Dean,  MD ND,  Martin Feldman, MD, Debora Rasio, MD, Dorothy Smith, PhD. "Death by Medicine." Life Extension March 2004


Compared  to  these  statistics (above),  many  ‘Natural’,  ‘Alternative’,  ‘Holistic’  (aka  Wholistic),  Complementary approaches  such  as  chiropractic,  acupuncture, nutrition, exercise;  these CAM approaches,  by research  statistics  seem  much  safer.

Comments  on  Chiropractic  (see at:   http://www.chiropracticissafe.org/ )
Spine: 15 February 2008 - Volume 33 - Issue 4S - pp S176-S183 doi: 0.1097/BRS.0b013e3181644600
“….Positive associations were found between PCP visits and VBA stroke in all age groups…..”  ( = visiting your MEDICAL  DOCTOR  seems  to  have  increased  risk  of  STROKE ),,,,  continued-“….Conclusion. VBA stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care….” =  NO increased risk from Chiropractic.
David  Cassidy (^^ above study Co-Author) states: “….Has it ever happened that a Doctor of Chiropractic has CAUSED a stroke?,  I cannot say it has never happened.  BUT, if it is happening, it is not happening at a greater risk then when visiting the General Practitioner Doctor of Medicine….”.

              This  research  could  surprise  you,  but  you  should  be  aware  of  the  relative  risks  of  the  different  treatment  approaches  you  may  utilize.  

+++++++++++++++++++++++++++++


I know I have given you a ton of information, websites, articles, patient handout sheets- I hope this helps you more fully understand your problem.  But the most important thing I want you to 'take home' from all of this is that the diagnosis of 'Sacralization' does not HAVE to mean the end of your sports participation.  The course of your condition is highly variable.  Along with this I would highly recommend that you visit the local Doctor of Chiropractic, preferably a DC with a sports injury specialty.  You could be/ should be able to participate, perhaps with modifications, precautions, preventative treatment.  I hope all of this info helps you in making health decisions in your future.


Do not hesitate to RE-contact me here at ALLexperts.com:
http://www.allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm  

Good luck in returning to your sport, good form, good health!

Dr. Victor Dolan, DC
Email Newsletter . . . . . . http://drvictordolan.chiroweb.com