Lower back pain caused by L5 issues

Yoga Discussion General Yoga
#1

Hello,

 I would appreciate any expert opinions here.  I have a partial sacralization of L5 with a right spatulated transverse process.  I had never known this, until I started experiencing it during savasana, and then at work and in bed.  The pain did not go away, even when I stayed away from yoga.  I went to a chiropractor, who found the condition and has helped me deal with most of the pain.  The problem is as follows - I didn't want to stop practicing yoga.  I know that you are never supposed to push in to pain, but since I never felt pain during the postures, I couldn't know what I was doing wrong.  I tried limiting certain movements (forward bends), keeping my back flat etc, but I was never able to figure out what I was doing wrong.  
 I have also heard all the stories about people who gently, over time, by respecting their boundaries, managed to surmount issues of pain, and gain flexibility.  I have also been told by some teachers that the pain is "transitional", and that if I were to do regular classes (5-7 times per week), the pain would eventually go away.  These are not teachers who advise students to push through pain.  While I would like them to be correct, I'm also very aware that the teachers aren't familiar with my particular back issue, and while they tell me to be careful I don't see how they can know how I should be careful if they don't know the risks of my condition.  I have to wonder if their advice may work for most but could be wrong for me.  Could anyone here offer any specific advice?

Zach

#2

Hello Zach,

One of the problems with this question you pose is that it is therapeutic in nature. A few members here are are professionals. They make their way on earth teaching yoga vocationally. That of course has to be balanced with the commitment to serve others - as many here have taken that inner oath to one degree or another. So what to do?

I’ll try and walk the line:-)

Every student, every body, every issue is different. And therefore there is no one remedy except in the minds of those rooted to dogma. Forward bends may work miracles for you. I don’t advise it and it makes no sense anatomically. But in your bod that may be the case. Who can say?

Some teachers haven’t the slightest idea how to alter a students practice (life) in order to facilitate healing. This is due in part to two things, very short trainings that could not possible make the time for enough learning and very poor trainings that even with time could not teach teaching. It is likely this way in every field. So caution should be employed when a yoga teacher advocates that the student self modify or protect themselves in class. That is actually OUR job.

True as you deepen your practice and become a very aware student you can cultivate an inner teacher that will serve you very, very well. Most people do not have this in the early years of their practice so it is simply irresponsible to place the onus on something that should be present in them 10 years later. At the same time, we as teachers must advocate that students take personal responsibility for their choices at every turn. Otherwise how else will change occur in our selves, our world, our consciousness?

My point? It is possible that a continued practice 5-7 times per week may move you through a transitional pain. Possible. Also perhaps not so. It is also possible that a practice like that would exacerbate your situation and thus your pain. Ah the wafting of responsibility that follows from choice.

Now what to do.
If you were my student (and you are not) I would advise two things. One that you work with a senior teacher with therapeutic training. And two that you consider a few private sessions to cultivate a personal practice and a sense for what is safe to do with your current situation AND what you might do to either live with it more easily or climb over it to the next mountain in your life.

#3

Hi Zach,

I’m going to start with a load of questions :slight_smile:

Has Bertolotti’s Syndrome ever been mentioned to you?

With Bertolotti’s, all lumbar extension and flexion basically take place at the wrong segment. This can obviously lead to problems down the line. Is the pain you experience sciatic-like in nature?

Do you have trouble with forward bends? Do you struggle to “get far down”?

What sort of treatment is your chiropractor employing? Flexion-distraction?

[quote=InnerAthlete;14064]
My point? It is possible that a continued practice 5-7 times per week may move you through a transitional pain. Possible. Also perhaps not so. It is also possible that a practice like that would exacerbate your situation and thus your pain. [/quote]
There is much wisdom here. I DO think that you can practice 5 times a week with benefit. But only if you utilize those aspects of yoga that serve rather than hinder your healing. A traditional western yoga class may not do that.

#4

David,

I have heard of Bertolotti’s Syndrome. It popped up when I googled my condition. My chiropractor didn’t identify it as such, but acknowledged that it matched what he found. I don’t know if my pain is “sciatic”. It’s usually in my lower back, and only occasionally goes to my right leg. But it’s primarily in my back.

Forward bends - I’ve had forward bend issues for a long time. I was born with juvenile rheumatoid arthritis (in a knee and in a finger joint), but it went away after two years of taking naproxin. Diagnosis at age 5 and it disappeared at 7. It was assumed that the reason for my tight ligaments was due to that. My chiropractor suggested that part of the tightness may related to the spine issue as well. What I have noticed in Yoga though is that my right leg is tighter than the left, and that it’s very very very slow to gain flexibility relative to the left.

Flexion distraction - I can’t say for sure as I’m not familiar with the term, but I youtubed it and it doesn’t resemble the procedure I undergo.

My own suspicion is that the pain doesn’t relate to the S1-L5 partial fusion, but from excessive motion in the joint above (L4-L5), and that if I strengthen my core it may help. I’ve been to an athletic therapist who’s pointed out how certain muscles overcompensate for others. I’m not sure if there are asanas that can isolate the muscles that need work and bypass the ones that overcompensate, but I’m relatively sure that a group class, even taught by an excellent teacher, wouldn’t have what I need.

Zach