Question
My names Dakota, im almost 21, i was in a car wreck almost 4 years ago and upon going to the chiropractor he discovered via X-ray that 2 of my vertebra were fused together and said it was like that from birth. He told me it would give me limited movement in my lower back and would get worse with age. I feel a tightness in my lower back like a rubber band wrapped around 2 vertebra. I always feel a constant pain but its not enough to bother me.  It does give me limited movement but just recently it has begun to hurt worse.  On a 1-10, 1 being least painful I've been feeling a solid 6 ( and the 1 starts with pain that bothers me, not just my usual ache) I don't want to take pain meds, I've had a bad past with them, my question is does it sound like Ankylosing spondylitis to you? And what would you recommend to help my future be pain and narcotic free. Thanks a million.
-Dakota
Huntington, WV.

Answer
Hi Dakota,
I am sorry you had such an unfortunate event being the car accident with continued pain.

Yes the fusion happened before you were born, this is known as a congenital anomaly, and no this is not a huge deal or really a factor as to why you are having pain.  It is called a congenital block vertebra, and is considered an anatomical variant of the development process while your spinal cord was developing. Block vertebra occur due to a lack of separation of the embryonal components that form the vertebra and intervertebral discs.  Yes this may limit lumbar spinal mobility very slightly but no more than you have ever noticed in your 21 years.  It is unlikely that the degree of change will get worse with age.  No, it does not sound like ankylosing spondylitis (AS) at all.   This is good news.

The tightness you are feeling has really nothing to do with the block vertebrae.  I don't know when the last time you saw a chiropractor was or how long after the accident you saw the doc and for that matter how long of a course of treatment did you do.  The muscles are in spasm for some reason which may have nothing at this point to do with the accident.

Your paraspinal muscles (the big muscles running down your back along the spine# along with muscles in your glutes (butt) and hamstrings are tight.  There is probably a few joints that need addressed chiropractically as well.  Medications really are not necessary at this moment unless there is uncontrolled continued discomfort with treatment.  I would highly suggest core strengthening exercises and spinal stability stretching and strengthening exercises and see a a highly recommended chiropractor.  

There are other factors associated with lower back pain, in your case it may or may not be directly correlated to the accident.  These other factors include, job type, weight, age, stature, fitness level etc...

If it were me, I would start a gentle stretching routine like yoga, (by the way, YogaX of the P90X series is phenomenal) and start off slow, like about 20-30 minutes worth of stretching.  See a chiropractor and make sure the joints are all good, except for the congenital block of course.  Give it a few weeks and lets see how you are doing. If no change I would recommend an MRI to see if there is something else going on.  It has been 4 years already, a few more weeks will not hurt you.

If you would like to follow up with me, please e-mail me!
I hope this helps and settles your mind.  Have a great day.

Sincerely,

Dr. Kevin Kaldy
Chiropractic Physician
NV. Lic #B929

[email protected]
www.lasvegaschiro.com