Q: I have pain at the back side of left leg (from hips to the ankle) for the last 6 months. There was no relief from the medicines given by the doctor. On the advice of a homeopathic doctor, x-ray was done, which showed: Radiographs of lumbo-sacral spine: AP & lateral views - Psoas shadows are normal. Lumber spine shows mild rotational scoliosis. Its alignment is normal. Partial sacralisation of L5 is noted on left side. Minimal osteophyte formation is seen in L3 vertebra anteriorly. No lytic lesion is seen. Neural arches and spine canal appears normal. Intervertebral disc spaces are preserved. Impression: Partial sacralisation with early spondylotic changes. What are the implications of this? What preventive measures should I take?

A:Partial sacralisation is often an incidental finding in plain x-rays of patients. It may or may not be associated with any symptoms. In the absence of other pathologies quite often this is designated as the cause of pain. All that means is one segment of spine is merging with another segment of spine. This may cause reduced mobility in one segment or increased mobility in another causing abnormal stress and strain and therefore, contribute to pain. More important is to examine clinically the nature of the pain and the signs associated with the problem. At times there could be an associated disc prolapse contributing to pain. This can be picked up only by a clinical examination. I would recommend that you show yourself to an orthopaedic surgeon before worrying about implications. Assuming the diagnosis to be right, all that is needed is a simple pain killer for pain and once the pain subsides, to start spinal extension exercises.