Ballet dancers are known for suffering a host of bodily aches and pains, and the back is one place where injuries and discomfort are common. Here's a look at four common back pain issues for ballet dancers in the lumbar, or lower spine, area (versus the cervical or thoracic spine). Those five vertebrae between the ribs and the pelvis can be a devil of a problem!

Sacralisation

While there are normally five distinct lumbar vertebrae, sometimes the fifth lumbar vertebra (L5) is fused with the sacrum (pelvis). This is known as sacralisation or a sacralised lumbar segment. Basically, this creates four lumbar vertebrae instead of five.

Ballet dancers who have this congenital anomaly usually notice a stiffness or lack of flexibility to the back during movements like port de bras. They may also experience a raised center of gravity, which can cause balance problems.

The solution to sacralisation is to create strong abdominal muscles to compensate for any weakness in the lower back. A physical therapist can suggest good exercises to achieve better abdominal strength.

Lumbar Strain

Lumbar strain is a frequent problem for male dancers who perform a lot of lifts during partnering work. This usually manifests as pain where the rather stiff thoracic spine meets the more flexible lumbar spine.

Fortunately, this is more of a muscular problem than a spinal one. Time off to reduce acute inflammation and a program of strength training can usually correct the issue, as well as learning proper lifting techniques.

Herniated Disc

The ultra flexible movements of ballet can cause stress at the lumbosacral junction, where the lumbar spine meets the sacrum. This can be the result of repetitive movement or trauma, such as a fall or twisting motion.

When this happens, the discs that provide the cushioning between the spinal bones lose water and therefore their cushioning ability. The soft center of the disc, known as the nucleus pulposus, can rupture and protrude between the discs. The disc presses on the nerves, especially the long sciatic nerve that runs from the lower back, over the hip, and down the back of the leg.

Symptoms of a herniated (bulging) disc include pain, numbness, tingling, and weakness. Mild symptoms can sometimes be treated with conservative (non-invasive) therapy, although many sufferers of a herniated disc ultimately wind up having surgery. And conservative treatments, such as taking NSAIDs (non-steroidal anti-inflammatory drugs) can mask pain and cause further injury.

Many dancers with a herniated disc elect to have it surgically treated. Fortunately, there is back surgery to correct the problem, which involves removing a portion of the disc and creating space around the nerve, can now be done on a minimally invasive basis.

Surgery for a herniated disc used to involve a long incision along the spine and months of recuperative time. Now, the surgical site is quite small, and patients are able to move around the same day. Dancers must still take time off and undergo some post-operative physical therapy, but most return to performing successfully.

Stress Fracture

Stress fractures, AKA spondylolysis or spinal breakdown, are another common back problem with dancers. This usually shows up as a one-sided pain during large movements, like grand battement or arabesque. The diagnosis can be confirmed with x-rays or an MRI.

Treatment for a spinal stress fracture depends on how long it is estimated to have been in existence. It can involve physical therapy and rehabilitation or, in more serious cases, immobilization with a brace, so the fracture can heal.

Back problems for dancers can quickly morph from a minor nuisance to a career-limiting catastrophe. If you experience any of the symptoms described above or have pain or limited movement in your back while dancing, it's best to consult your health care provider immediately. The sooner you diagnose and deal with the issue, the sooner you'll get back to the barre in good form.