L5 lumbar sacralization: What is it, and how to treat it?

lumbar sacralization

L5 lumbar sacralization is a condition of the spine where the fifth vertebrate (L5) is fused to the sacrum bone. It is a congenital anomaly that occurs in the embryo, and which can affect only one side or both in a total or partial way.

What is lumbar sacralization, and should we worry if the doctor gives us this diagnosis? Is it related to back pain? What are the treatments to reduce the pain when it is present?

This popular article explains everything you need to know about this spinal condition.

Definition and anatomy

In the vertebral column, there are 5 vertebrae lumbar located in the lower back. Just below, there are 5 sacral vertebrae of triangular shape and welded, and which ends in the coccyx.

The vertebral column forms during embryonic development. In some cases, changes can cause congenital malformations, resulting in an abnormality in the vertebrae, for example.

Lumbar sacralization

Lumbar sacralization is a type of birth defect in which the last lumbar vertebra (L5) is completely or partially fused with the sacrum (or the iliac bone in some cases). This fusion can occur on one side only (hemi sacralization) or on both sides.

Due to lumbar sacralization, the L5 vertebra appears more like a sacral vertebra. This is where the term comes from “L5 sacralization”.

The exact cause of sacralization is not yet known. We know that it occurs during embryonic development, when the vertebrae begin to ossify, around the eighth week. It is believed that a genetic predisposition could cause this spinal condition.

It is a more common condition than one might imagine, with an estimated incidence of 4-36% Population. In people under the age of 30, it is estimated that 18,5% are affected by lumbar sacralization.

Sacralization should not be confused with lumbarization, another birth defect of the spine. Less common, the lumbarization is a condition where the first sacral vertebra (S1) is separated from the other sacral vertebrae instead of being fused to it. It is then said that it is part of the lumbar spine, and can also cause lower back pain.


The diagnosis is made by medical imaging. Generally, an X-ray or CT scan is sufficient to determine the presence of the sacralization, as well as its characteristics (bilateral, unilateral or hemi-sacralization, fused with the iliac bone, etc.).

We use the Castellvi's classification to better describe lumbar sacralization. 

The Castellvi classification is as follows:

  • Type 1: a fusion of at least 19 mm in width on one side (hemi sacralization), or on both sides.
  • Type 2: incomplete fusion with formation of a pseudojunction on one or both sides.
  • Type 3: complete fusion of L5 and sacrum on one side or the other
  • Type 4: combination of type 2 and type 3.

Symptoms: Consequences of sacralization 

The sacralization of the last lumbar vertebra is not necessarily synonymous with back pain. Indeed, it can be asymptomatic in several cases, mainly due to the adaptability of the human body. Even today (and despite scientific studies), the relationship between sacralization and low back pain is unclear. 

On the other hand, it is possible that lumbar sacralization causes symptoms in some people. A survey on low back pain found that the number of people with low back pain AND who also had sacralization ranged from 6 to 37%. Furthermore, another survey suggested that the presence of L5 sacralization may aggravate pain in those who already suffer from back pain.

Symptoms will vary depending on the severity of the malformation, and each individual. In the presence of lumbar pain associated with sacralization, we speak of “ Bertolotti syndrome"

From a biomechanical point of view, it must be understood that an L5 vertebra fused with the sacrum modifies the functioning of the lumbar region and the sacrum. In particular, it affects trunk mobility, posture, the biomechanics of the upper and lower vertebrae, etc.

For example, sacralization can affect the center of gravity at the base of the spine. As the fifth lumbar vertebra is fused with the sacrum, the fourth lumbar vertebra (L4) therefore becomes the "last" lumbar vertebra.

Since the L4 vertebra is not anatomically suited to perform the same support functions as the L5 vertebrae, this causes compensations and overuse of this region.

In short, lumbar sacralization can remain asymptomatic if the body succeeds in adapting from an anatomical and biomechanical point of view. On the other hand, this condition can also affect back movements and posture, especially if the sacralization is unilateral. The overlying and underlying vertebrae will have to work more, which can cause dysfunctions.

More specifically, here is what can be observed in some people with lumbar sacralization:


If the condition remains asymptomatic, no treatment will be put forward. On the other hand, if sacralization causes pain, here are some frequently used treatment modalities:

  • Painkiller and anti-inflammatory medication
  • Muscle relaxants in the presence of muscle spasms 
  • Natural products for pain management
  • Massages and mobilizations from the physiotherapist (physiotherapist) or osteopath 
  • Infiltration to reduce inflammation as needed
  • Medicine and alternative therapies (acupuncture, cupping etc.)
  • Surgery as a last resort (to treat the consequences of sacralization)

In addition to the treatments mentioned above, there are several products and accessories available on the market to relieve lower back pain related to lumbar sacralization. It should be remembered that these tools generally provide temporary relief, and should be used sparingly.

Among the products recommended by our professionals, we have:

Among the best-known accessories are:

acupressure mat
Wellax acupressure mat with cushion – specifically relieves tension and promotes circulation – massage mat in a set including acupressure cushion and carrying bag
  • 🧘 𝐔𝐍 𝐄𝐍𝐒𝐄𝐌𝐁𝐋𝐄 𝐔𝐍𝐈𝐐𝐔𝐄 𝐓𝐎𝐔𝐓-𝐄𝐍-𝐔𝐍 – Wellax acupressure set leaves nothing to desire: For a complete and perfect wellness experience, you will receive a matching spiked cushion with our acupressure mat!
  • 🧘 𝐋𝐈𝐁È𝐑𝐄 𝐃𝐄 𝐋𝐀 𝐓𝐄𝐍𝐒𝐈𝐎𝐍 – Our fakir mat stimulates the muscles, promotes circulation and can thus effectively relieve tension. This is how you fight annoying back and neck pain!
  • 🧘 𝐃𝐈𝐒𝐒𝐈𝐏𝐄 𝐋𝐄 𝐒𝐓𝐑𝐄𝐒𝐒 𝐑𝐎𝐔𝐓𝐈𝐍𝐈𝐄𝐑 – Whether after a training session, a match or a hard day work: The Wellax acupuncture mat is the ideal support for releasing daily tension. Pure relaxation for body and soul!

Last updated on 2024-06-17 / Affiliate links / Images from the Amazon Partners API

Local alternative (French product)

Lumbar belt heated
GINEKOO Heated Back Belt, Breathable Back Belt with Rechargeable Battery Heating to Relieve Lower Back Pain, Lumbar Support for Herniated Discs, Sciatica(XL)
  • 【Powerful 360° Support】With 4 stainless steel supports and 2 steel springs placed along the waist, the back brace for heavy lifting provides strong 360° vertical support for the lower back and allows for optimal decompression of the spine, thereby preventing back injuries caused by lifting dumbbells, prolonged standing or sitting, household chores and work.
  • 【Relieve Pain】The ergonomic back support provides strong support for the lower back and abdominal muscles, increasing pressure around the waist to prevent fatigue, strain and other back-related injuries. Relieve waist muscles, herniated discs, sciatica, scoliosis, etc. when wearing the back support belt.
  • 【3 Heating Modes】The back brace for lower back pain contains a heating pillow fixed by Velcro, which you can easily operate via the controller. There are 3 heating settings (low, medium, high) that allow you to adjust the temperature as needed to promote blood circulation and relieve back pain.

Last updated on 2024-06-17 / Affiliate links / Images from the Amazon Partners API

Ergonomic back cushion
Car Lumbar Cushion for Back Back Support for Office and Car Chairs, Ergonomic for Back Seat
  • ✨Premium Material: Our lumbar support cushion is filled with new temperature sensitive sponge, the lumbar support can adjust the contour of your back according to the temperature. The outer layer of lumbar cushion is made of high quality breathable fabric. The back support cushion fabric is comfortable and soft, not easy to fade. The parts of the lumbar cushion have been certified and are safe and harmless to human health.
  • ✨High-quality design: The back support cushion for chair is ergonomic, and the pillow for back pain has a partitioned design, the memory foam back cushion can support your back curve and promote healthy posture. The lumbar support cushion for chair uses elastic straps to keep the lumbar support cushion for sofa firmly fixed on the seat.
  • ✨Protect your health: With our car back support, you can better protect your spine, car back support office chair Helps relieve lower and middle back tension caused by prolonged sitting or driving. If you often experience back pain due to prolonged sitting, you should definitely try an office chair back cushion.

Last updated on 2024-06-17 / Affiliate links / Images from the Amazon Partners API

Local alternative (French product)

massage gun
Muscle Massage Gun ALDOM Deep Muscle Massager Massage Device with 30 Adjustable Levels, 6 Massage Heads and LCD Display for Relieving Muscle Aches and Stiffness
  • DEEP TISSUE MASSAGE GUN – ALDOM Muscle Massage Gun for Athletes is ideal for relieving muscle pain, soreness and stiffness, promoting blood circulation and helps speed up warm-up and cool-down. It also helps restore the body faster and can be used as your percussion massager at the gym or sports club, is held with one hand and has a comfortable handle.
  • 6 MASSAGE HEADS + 30 SPEED - The deep tissue massage gun comes with 6 different massage heads to help relieve sore muscles, 30 adjustable speed modes, Choose the speed and massage heads that best suits your needs. your needs (1 to 800 pulses per minute) to target different body parts and muscle groups, Integrate a percussive massage experience. Reduce muscle recovery time.
  • SUPER QUIET AND POWERFUL MASSAGE GUN - Professional handheld percussion massager. Featuring a powerful, high-penetration motor, the deep tissue massager is designed to send waves of relaxation and relief throughout the body, and increase everyday mobility and flexibility with percussive therapy for pain relief joints and muscle pain and prolongs the duration of muscle massage
BURNNOVE Muscle Massage Gun 99 Adjustable Speeds Massage Gun Electric Deep Muscle Massager Portable 8 Heads 2550mAh 3300 RPM LED Touch Screen Low Noise Relieve Pain
  • 💪RELIEVE MUSCLE PAIN – Our massage gun can help relieve tight muscles, aches and stiff backs, relaxes tender tissues. The deep muscle massager quickly removes lactic acid produced after exercise, significantly reducing muscle recovery time.
  • 💪8 MASSAGE HEADS + 99 SPEEDS – The powerful massage gun contains multiple easy-to-replace massage heads that can care for different body parts and muscle groups. The 99 speed adjustment parameters allow you to better choose the vibration speed to reach you the most comfortable state.
  • 💪LED TOUCH SCREEN – The muscle massage gun is equipped with an LED screen, which can display the speed and battery percentage. You can increase or decrease the speed of the electric massager by simply pressing the "+" or "-" button, and it can be adjusted quickly with a long press, which is easy and convenient to use.

Last updated on 2024-06-17 / Affiliate links / Images from the Amazon Partners API

Local alternative (French product)

Although L5 sacralization cannot be corrected from an anatomical point of view, it is possible to act on the functional consequences related to this condition. For example, core mobility and strengthening exercises will reduce the overload on the related vertebrae. Specific stretches will reduce stress on the lumbosacral region.

The diagnosis of lumbar sacralization is therefore not inevitable, and it is possible to continue one's professional, sporting or leisure activities following appropriate treatment. A qualified health professional will be able to guide you if you ever suffer from this condition.

What about natural remedies?

Like accessories and anti-back pain products, natural products and grandmother's remedies are very popular with people suffering from back pain.

Often, these remedies include anti-inflammatory properties to relieve various body pains.

On the other hand, it should be noted that most of these natural products are not scientifically proven. It is therefore important to speak to your doctor before using them, particularly to avoid any interaction with your medications.

Natural remedies that could relieve symptoms include:


Thanks to its antioxidant and anti-inflammatory powers very powerful, turmeric is one of the most used plants in a culinary and therapeutic context. The composition of turmeric is essentially made of essential oils, vitamins (B1, B2, B6, C, E, K) and trace elements. But it is to its composition rich in curcumin and curcuminoids that we owe them and calm skin of this spice.

Powerful Turmeric Capsules 500mg with 95% Curcumin Extract – 180 Vegan Capsules (6 Months) – Turmeric (50:1), Black Pepper (30:1) and Ginger – High Absorption Turmeric Capsules – Made in EU
  • WHY CHOOSE OUR TURMERIC AND BLACK PEPPER CAPSULES? – Turmeric is a very well-known plant…
  • POWERFUL TURMERIC CAPSULES - Turmeric is an excellent source of Vitamin C, antioxidants,…
  • IDEAL AND PRACTICAL FORMULA – The powders we use are delicately harvested,…

Last updated on 2024-06-17 / Affiliate links / Images from the Amazon Partners API


In addition to the particular flavor it brings to cooking and its aphrodisiac properties, ginger is a root well known for its anti-inflammatory powers. THE gingerol gives it its anti-inflammatory action. It is an active component acting on the inflammatory pain related to chronic joint inflammatory diseases, including rheumatoid arthritis, lupus, rheumatic diseases, etc. It has been proven that this active element is also effective in acting on the inflammation linked to arthritis and sciatica. Ginger also has other benefits thanks to its high potassium content and its richness in trace elements (calcium, magnesium, phosphorus, sodium) and vitamins (provitamin and vitamin B9).

Ginger Foot Patches, Pack of 30 Ginger Detox Patches, Anti Swelling Ginger Detox Patch, Foot Detox Patch for Deep Cleansing, Improve Sleep
  • 【Natural Ginger Foot Patches】: Natural Foot Detox Patch with Ginger and…
  • 【Ginger Anti Swelling Detox Patch】: Ginger Detox Patches are natural,…
  • 【Removes Body Toxins】: Ginger Foot Patches helps reduce the buildup of…

Last updated on 2024-06-17 / Affiliate links / Images from the Amazon Partners API


Omega-3s are polyunsaturated fatty acids that play a very important role in the functioning of our body. They are provided by food in three natural forms: docosahexaenoic acid (DHA), alpha linolenic acid (ALA) and eicosapentaenoic acid (EPA). Beyond their action on the brain and the cardiovascular system, omega-3s prove to be very effective against inflammation. Indeed, they have the ability to act on the inflammatory mechanisms in osteoarthritis by slowing down cartilage destruction, thus they reduce the intensity of osteoarthritis pain. Sciatica, being most often linked to an inflammation secondary to a herniated disc, it can also respond to omega-3 provided it is consumed regularly. 

Omega 3 Wild Fish Oil 2000mg – 240 Capsules (120 Days) – High Concentration of EPA (660mg) & DHA (440mg) Supports Heart Function and Normal Vision – Manufactured by Nutravita
  • ✔ WHY NUTRAVITA OMEGA 3 FISH OIL? – Our omega 3 comes naturally from the rich waters of the Peruvian coast. The oils are then distilled for increased purity to provide the highest levels of contaminant-free acids – EPA and DHA, removing metals, PCBs and other toxins. 2 capsules daily, our supplement provides a maximum strength of 660 mg EPA and 440 mg DHA. 240 capsules per bottle for a 4 month supply.
  • ✔ WHY OMEGA 3? Each recommended daily dose of our premium Omega 3 fish oil supplement provides high-potency essential fatty acids – Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA) which both help support various functions bodily, especially in the normal functioning of the heart. DHA supports the maintenance of normal brain function and normal vision. All these claims are supported by EFSA
  • ✔ WHAT INGREDIENTS ARE USED AT NUTRAVITA? – We have a dedicated team of pharmacologists, chemists and researchers who work to find the finest and most beneficial ingredients, allowing us to provide advanced, high strength vitamins and supplements that do not contain dyes or flavorings artificial. From *fish* which may NOT be suitable for people with allergies. The soft capsule is made from (bovine) gelatin.

Last updated on 2024-06-17 / Affiliate links / Images from the Amazon Partners API

Lemon eucalyptus

Eucalyptus is a plant most often used in the form of herbal tea or essential oil. She would have anti-inflammatory effects which give it the ability to act on the bone and joint pain in general and the pain of sciatica in particular.

Mystic Moments Lemon Eucalyptus Essential Oil – 100ml – 100% Pure
  • Eucalyptus Citriodora Essential Oil.
  • 100% pure.
  • Botanical name: eucalyptus citriodo.

Last updated on 2024-06-17 / Affiliate links / Images from the Amazon Partners API


Wintergreen is a shrub from which a very interesting essential oil is extracted. It is one of the essential oils most used in aromatherapy. This oil, extracted from the shrub of the same name, is used in massage to relieve sciatica and act like a analgesic. Indeed, it provides a heating effect thanks to its ability toactivate blood circulation locally.

Puressentiel – Wintergreen Essential Oil – Organic – 100% pure and natural – HEBBD – 30 ml
  • DIRECTIONS FOR USE: Refer to the instructions or ask your pharmacist for advice, This…
  • PURESSENTIEL DNA: A range of 55 essential oils essential for well-being in the…

Last updated on 2024-06-17 / Affiliate links / Images from the Amazon Partners API


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