Q: I am a 27 years old female suffering from sacralisation. Is physiotherapy the only solution for sacralisation? I experience no improvement in my leg, knee and back pain. Should I continue with my physiotherapy sessions? Do I need to undergo a surgery for this?

A:Usually the 5 Lumbar vertebrae (backbones between the chest/ribs and the hips) are separate, distinct bones, just like the 19 above them (12 thoracic or dorsal that typically each have ribs, and the 7 cervical in your neck).

Sometimes the bottom lumbar vertebra (#5) looks like it's trying to fuse with the sacrum. It's not completely separate, but it's not completely fused (usually) like the other bones in the sacrum (which form the triangular bottom of the spine and connect to the two hip bones through the sacroilliac joints). This is sacralisation. These situations might cause a tendency to get back pain and your pain probably led to the x-ray that revealed this condition in you. Nothing surgical needs to be done about the condition.

The best advice is to (a) slowly strengthen your back, and (b) strengthen your back slowly.

In addition, spinal manipulation and flexion exercises aimed at regaining total spinal motion and reducing pain can also be tried. The pain relief and increase in mobility can be slow but it will definitely happen. Continue with your Physical therapy with faith in your treatment.