If you have low back pain that keeps returning, a lumbosacral transitional vertebra (LSTV) may be part of the cause. This anatomical variation is more common than most people realize, and for some patients it creates extra stress in the lower spine that leads to chronic discomfort.
At Cole Pain Therapy Group in Memphis, we help patients across Bartlett, Lakeland, Arlington, and surrounding areas with hands-on, personalized care that addresses the true source of back pain rather than the symptoms alone.
Below, you will learn what an LSTV is, why it may cause pain, and the most effective ways to find lasting relief.

Treatment focuses on reducing irritation, improving joint motion, and restoring balance in how the spine, pelvis, and hips move together. Research shows that many people with LSTV improve with conservative care when treatment is tailored to their movement patterns.
Hands-on treatment can improve the motion of the lumbosacral joints. Studies show that spinal manipulation, mobilization, and targeted exercises can help patients with LSTV reduce pain and restore proper mechanics.
LSTV often changes how loads transfer through the L4, L5, and sacral regions. Strengthening the hips, core, and glutes can reduce stress on irritated joints. Mobility work for the hips and thoracolumbar region also supports better movement.
Muscles around the low back and pelvis often tighten to compensate for restricted motion in the transitional segment. Soft tissue therapy decreases guarding and improves flexibility.
Many patients adopt unhealthy movement habits because of pain or stiffness. Retraining posture and everyday movement helps prevent recurrence and improves long-term comfort.
Image-guided injections may help calm irritation at the pseudo articulation or near irritated nerve roots. These do not solve the mechanical issue but may reduce inflammation.
Surgery is considered only for severe cases that do not improve with conservative care. Procedures may involve removing the pseudo joint or stabilizing the segment.
Most patients do well without surgery when treatment focuses on both the transitional vertebra and the surrounding biomechanical issues.
Yes. Many people with LSTV experience low back pain, even though some remain symptom-free. Pain often develops because the transitional segment forces the spine to move differently.
Common reasons LSTV causes pain include:
Increased stress on joints above the transitional segment
Early degeneration or facet joint irritation
A painful pseudo joint that becomes inflamed
Nerve irritation from altered mechanics
Connection to Bertolotti Syndrome, which causes chronic low back pain
Patients often describe a deep ache in the lower back, stiffness with activity, or pain that worsens with bending, twisting, or prolonged sitting.
Yes. An LSTV is congenital, meaning it develops before birth. It happens when the lowest lumbar vertebra forms an extra connection with the sacrum. This connection may be:
A partial fusion
A complete fusion
A pseudo joint with abnormal articulation
Symptoms usually appear later in life when the area becomes irritated or overloaded.
LSTVs are very common. Imaging studies show that:
Up to 30 percent of people have some form of LSTV
People with chronic low back pain are more likely to have an LSTV than those without symptoms
Many individuals do not know they have it until they receive imaging
Because it is so common, proper diagnosis and individualized care are important for long-term comfort and movement.
Our team provides evidence-based treatment designed to reduce pain, improve mobility, and support long-term spinal health. Patients from Memphis, Bartlett, Lakeland, and Arlington choose us because we combine:
Hands-on chiropractic care
Corrective exercise and strength training
Movement retraining
Soft tissue therapy
Comprehensive education and prevention strategies
If you have recurring low back pain and suspect an LSTV or Bertolotti Syndrome, you do not have to manage it alone. With the right plan, meaningful and lasting relief is possible.
Call today to schedule your convenient appointment.
Pre-register your important health information on your phone or computer to save time.
Meet your new doctor for a customized plan and start moving toward your goal!
We are the Memphis area’s top-rated chiropractic group, providing you with gentle chiropractic care, dry needle therapy, exercise therapy, and therapeutic massage.

2845 Summer Oaks Dr, Memphis, TN 38134
(901) 377-2340
Life Shouldn't Hurt!
You Deserve To Feel Great. We Can Help!
Your go-to Chiropractor in Memphis, TN

Richard L. Cole, DC, DACNB, DAIPM, FIACN, FICC
Jeffrey D. Luebbe, DC, CCRD, CCSP
W. Steven Vollmer, DC, DAAPM
Bradford J. Cole, DC, MS, CSCS
J. Colby Poston, DC
Daniel H. Smith, DC
2845 Summer Oaks Dr., Memphis, TN 38134
(901) 377-2340
Monday – Friday:
8:00 AM – 6:00 PM
Saturday :
8:00 AM – 12:00 PM
Walk-ins are Welcome!
© 2025 Cole Pain Therapy Group, All Rights Reserved