The lumbosacral junction is the area between the lumbar spine and the sacrum. Nerves leaving the spinal canal in this area travel down to the hindlimbs. The term lumbosacral disease encompasses many different disease processes that can cause pain and compression of the spinal nerves here. Examples include: compression from possible intervertebral disc material, abnormal alignment of the vertebrae, extra congenital vertebrae, thickening of the spinal ligament, and/or arthritis. Compression in this area can cause a pet to experience pain in the lower back and weakness in one or both hind legs.
Along with pain in the low back, one of the symptoms we often observe in pets with lumbosacral disease is decreased or loss of awareness of where the hindlimbs are in space. This is called delayed proprioception. Weakness of one or both hind legs is also common due to decreased nerve signal at the lumbosacral junction. If nerve impingement is severe enough, we can see decreased pain sensation and changes in your pet’s bowel and bladder function, including incontinence.
Our first step in assessing a pet for lumbosacral disease is through radiographs (x-rays). Radiographs can show any changes in the bony structure of your pet, indicating the degree of potential arthritis. However, radiographs typically do not show changes in soft tissue structures. An MRI is the gold standard in fully diagnosing lumbosacral disease and can help determine the cause and severity of spinal canal involvement.
If symptoms are severe enough, a consult with a neurologist and surgical removal of a portion of the affected vertebrae may be warranted. However, lumbosacral disease is often treated conservatively with rehab. Our main goal at the beginning of rehab is to decrease pain and inflammation surrounding the lumbosacral junction to reduce pressure on the nerves. This is done through modalities such as laser, TENS (transcutaneous electrical nerve stimulation), PEMF (pulsed electro-magnetic field therapy), and therapeutic ultrasound. We can also use massage and other hands-on techniques to reduce muscle tension and pain. Then, we focus on maintaining a comfortable range of motion through the spine within your pet’s tolerance. We also focus on building core strength to help provide stability to the lumbosacral area. If there are neurological signs present, we focus on bringing increased sensory input to the limbs to help improve proprioception and awareness of the hind limbs. Once proprioception is improved, we work on hind limb stability. We start with positional balance exercises and then progress into dynamic movements.
