Guide on Spina Bifida Back Pain Causes & Treatment (FAQ)

Back pain is one of the primary symptoms associated with spina bifida (SB). This pain can affect any area of the back, the upper and the lower portions. Having pain for even just a few seconds can be pretty daunting, stressful, and obviously uncomfortable.

Needless to say that finding pain relief is essential, as this constant pain can greatly reduce one’s quality of life. There are many ways to relieve back pain associated with SB, and in this article, we will review those pain relief methods and much more  [1].

Can Chiropractic Therapy Help Spina Bifida Back Pain?

Chiropractic therapy can help to relieve spina bifida back pain. In the Journal of Chiropractic Medicine, a 2014 scientific article outlined a case report on chiropractic care for acute lower back pain and incidental spina bifida occulta managed with high-velocity, low-amplitude manipulation [9].

In this article, a 10-year-old boy was referred for chiropractic care by his pediatrician, and high-velocity low-amplitude treatment, which is a form of chiropractic treatment, was administered for lower back pain. The child experienced pain relief after six visits with no adverse effects being reported [9].

Does Spina Bifida Back Pain Get Worse With Age?

Yes, spina bifida back pain gets worse with age, just like the other problems that are associated with the condition. For example, spinal cord tethering tends to worsen during aging, where the spinal cord becomes attached to surrounding tissue and can result in worsened back pain along with skin sores, loss of sensation, scoliosis, and urinary tract infections or leakage [10].

Can you Get an Epidural if you have Spina Bifida Occulta?

Epidural for spina bifida occulta

Yes, you can get an epidural if you have spina bifida occulta; however, there may be complications, as neuraxial procedures have a higher rate of complications in people with SB. Notwithstanding, there are reports of successful spinal and epidural anesthesia in patients.

There is also a heightened risk of an accidental dural puncture resulting from the less than normal anatomy. As such, a lesser quantity of local anesthetic is recommended for an epidural in spina bifida occulta patients because of its risk of excessive cranial spread [11].

Can Spina Bifida Occulta Cause Lower Back Pain? 

massage for spina bifid back pain relief

Yes, spina bifida occulta can cause lower back pain, although it is primarily asymptomatic. When SB causes discomfort, these issues may include back pain, enuresis, motor or sensory dysfunction, and posterior disc herniation [9].

What Kind of Back Pain do those with Spina Bifida Myelomeningocele Feel?

The type of back pain that those with spina bifida myelomeningocele feel is often described as extreme pain. Myelomeningocele is the most severe of the various spinal neural tube abnormalities, and as such, this intense pain is expected. [12].

Myelomeningocele can immobilize the spinal cord and produce extreme pain. However, surgery is typically used to remedy this problem [8].

Can Spina Bifida Occulta Cause Sciatica?

Yes, spina bifida occulta can cause sciatica. A study that looked at peripheral neurological involvement as the first manifestation of spina bifida occulta found that a lot of patients with roentgenograms taken to evaluate low back pain and sciatica are found to have a SB Occulta. [13].

Sciatica is pain that spreads down the route of the sciatic nerve, which runs from the lower back to the hips and buttocks and down each leg. Sciatica typically affects only one side of your body. Many people who had x-rays done to analyze their back discomfort and sciatica were discovered to have SB. Adults with this complicated birth abnormality involving the spinal canal, meninges, spinal cord, or tail canal may experience neurological and/or urinary issues [14].

Sciatica is most usually caused by a herniated disk, a bone spur on the spine, or a constriction of the spine (spinal stenosis). This results in inflammation, discomfort, and numbness in the afflicted leg. Although sciatica pain can be excruciating, most instances recover in a matter of weeks with non-surgical therapy. Patients with severe sciatica who have considerable limb weakness or bowel or bladder abnormalities may be candidates for surgery [14].

Can Spina Bifida Occulta Cause Severe Back Pain?

Spina bifida can cause severe back pain, although this is not extremely common. In a few cases, severe pain is one of the symptoms that affect adults and children diagnosed with the condition [9].

Acute low back pain is prevalent, and chiropractic manipulative therapy is routinely used to treat it. When compared to traditional medical therapy, high-velocity low-amplitude (HVLA) is a beneficial therapeutic technique for acute low back pain. When compared to prescription nonsteroidal anti-inflammatory medicines, high-velocity, low-amplitude adjustments are a better therapy [9].

Latent double vertebrae are usually asymptomatic; however, in the general population, symptoms may include back discomfort, enuresis, motor or sensory dysfunction, and other issues. A physician should explore any new, persistent, or worsening discomfort.

A physical exam and a lengthy talk about how the pain affects your life and activities are usually part of the assessment process. If the pain has continued for weeks or months and the underlying issue cannot be addressed, you may be suffering from chronic pain [9].

How Can I Get Spina Bifida Occulta Back Pain Relief?

You can get spina bifida occulta back pain relief from a number of interventional therapies, including analgesics and physiotherapy. In addition, postural modification, massage therapy, chiropractic intervention, and psychologic support can relieve back pain associated with SB. If symptoms appear, treat them on their own. For instance, if a person has back pain, he or she may benefit from physical therapy or pain medication to help manage it [15].

If tethered cord syndrome is caused by spina bifida occulta, straightforward surgery to release the cord may be performed. Although surgery is typically effective, the cord can re-tether, and the procedure may need to be done numerous times [15].

Can a Chiropractor help with Spina Bifida Occulta?

spina bifida backpack relief from physical therapist or chiropractor

Chiropractic intervention can help to treat symptomatic spina bifida occulta, particularly the pain it causes. Furthermore, individuals with spinal abnormalities may have additional spine disorders, such as herniated discs, and chiropractic may be beneficial in these cases as well [16].

Manipulation and adjustments can be performed regularly to move the vertebrae and nerves away from bulging or ruptured spinal discs, thereby alleviating pain and symptoms.

Can Spina Bifida Occulta Cause Problems Later in Life?

Spina bifida occulta can cause problems later in life, although it is the least severe type. Spina bifida occulta is often known as “hidden” spina bifida. There is a slight gap in the spine with it but no opening or sac on the back. The spinal cord and nerves are typically normal, and as such, spina bifida occulta is frequently identified in late childhood or maturity. This form of SB does not generally result in any impairments [17].

There are several kinds of Spina Bifida Occulta that might be problematic in the future. They include;

  • Lipomyelomeningocele and lipomeningocele—this is similar to a tethered spinal cord, but it is linked to a benign fatty tumor.
  • Fatty terminate—a fatty mass at the interior end of the spinal cord
  • Diastematomyelia (split spinal cord) and diplomyelia—the spinal cord is divided in two, generally by a piece of bone or cartilage.
  • Dermal sinus tract (with spinal cord involvement), the spinal canal, and the skin of the back is joined by what seems to be a band of tissue [17].

(Video about the problems that SB causes later in life)


Treating Back Pain for Spina Bifida in Adults

older woman with spina bifida riding in wheelchair

Treating back pain for spina bifida in adults can be done using a few approaches, and these treatments tend to be a little different from the treatment given to children. Also, adults may experience some amount of discomfort related to changing their posture [1].

However, with more treatment and practice, it becomes a habit, making posture adjustment much easier. As such, adults can look forward to enjoying some of the benefits of fixing their posture, such as alleviating their back pain and allowing them to have a better quality of life [1].

One important factor that significantly contributes to finding the most appropriate treatment is determining the cause of the back pain. After that, the adult with spina bifida should adopt and practice the changed postures that provide back pain relief without causing any structural damage. Eventually, they get used to the advised postures as they begin to experience a significant decrease in back pain [1-2].

These kinds of problems can be corrected, but only if they’re found and diagnosed.

There are several options that can be used for treating adult back pain, including:

  • Pain medications [3]
  • Out-patient hospital or clinic
  • Psychotherapy
  • Massage Therapy
  • Water (hydro) Therapy

Treating Back Pain for Spina Bifida in Children

Treating back pain for spina bifida in children should start as early as possible. Early intervention will help increase their opportunity to become engaged in more activities during their childhood. The more engaged they are as children, the more prepared they will be for adulthood.

Early treatment of back pain can also help to improve your child’s quality of life [1].

Treating back pain for spina bifida in children can also boost mobility and facilitate an enhanced experience or benefit of other treatments that target other issues, such as occupational therapy geared toward developing and improving fine motor skills [1].

Here are some of the treatment modalities that are typically used for treating back pain in children with spina bifida:

  • Infant massage therapy [4]
  • Surgery
  • Analgesics
  • Water therapy

10 Ways on How to Ease Spina Bifida Back Pain

How to Ease Spina Bifida Pain is a situation that many parents, caregivers, and adults with the condition are faced with, and most times, this is a daily issue. Thankfully, there are multiple treatment options that both children and adults can benefit from. While these may not cure the back pain associated with SB, they can offer optimal pain relief for many [5].

Below, we will look at the top 10 ways to relieve back pain for SB.

  • Postural modification

Postural modification for back pain associated with SB involves educating the patient and caregiver about postural conditions that are likely to be responsible for causing back pain. The patient is further advised to adjust their postures when sitting or lying to help alleviate the pain. Changing their posture alone can significantly reduce spina bifida lower back pain [5].

Postural modification therapy is provided by a physical therapist, and it alleviates some of the pressure on damaged nerves. Additionally, postural modification is said to provide longer-term relief than analgesics [6].

  • Psychological Support

An individual’s psychological state can also contribute to their pain experience. Believe it or not, the state of mind one is in greatly affects how one perceives pain. As such, mood, stress levels, depression, and overall psychological health and wellness also can increase their chances of experiencing back pain [7].

Think about it, have you ever been frightened and felt a shocking sensation along your back?

Pain is a physical and emotional problem; therefore, it is encouraged that the patient is provided with psychological support from family or from healthcare providers.

Psychiatric therapy helps to relieve the anxiety of the patients. Thus, the patient is more relaxed, and their fears are addressed. With familial support, the degree of success of this therapy increases several times [1,2].

  • Physiotherapy and Craniosacral Therapy

The primary purpose of physiotherapy is to help the patient with their posture to alleviate back pain but also in the development of everyday movements and muscle functions.

Physiotherapy also helps to relieve muscle cramps that can be very painful, and in combination with craniosacral therapy (a form of alternative therapy body touch focusing on the synarthrodial joints of the skull), may help in relieving tightness in their muscles [1-2].

This collaborative effort may also aid with balancing their hormone levels and normalizing body functions [1-2] while also fixing their posture and reducing back pain.

  • Orthopedic Evaluation

An adult or child affected by spina bifida should be regularly evaluated by an orthopedic specialist for routine evaluation of their bone and muscle development. This practice facilitates early detection and treatment, which promotes better patient outcomes. Of note, orthopedic evaluation can identify porous bones that cause severe pain and abnormal development of bone and muscle [2].

  • Central Nervous System Evaluation

The central nervous system development should be examined and evaluated by the neurosurgeon. In case of any problem, it should be dealt with immediately. For instance, in the case of hydrocephalus shunting, it becomes inevitable. It is a surgical procedure in which a shunt is placed in the brain to drain excessive nutritional fluid (cerebrospinal fluid) from the brain. A common symptom of hydrocephalus is a headache [5].

  • Upper Spina Bifida Back Pain Management

Two factors causing upper Spina Bifida back pain can be posture and tension (in women, the weight of their breasts can also negatively affect their posture). These factors determine the degree of pain.

However, back pain can also be caused by a shunt or rod which is poking through the skin. If the patient has a painful rod or shunt in the back, it should be evaluated and appropriately fixed so that complications can be avoided. If the causal factor is mechanical, it can be relieved by physiotherapy. Pain can also be relieved by simple analgesia in most cases. Sometimes physiotherapy along with analgesia is needed [2].

  • Lower Spina Bifida Back Pain Management

Lower back pain in Spina Bifida can be associated with factors such as a tethered cord which becomes symptomatic and causes pain. There may be difficulty in walking and bladder problems as well. If these kinds of problems are found and diagnosed early, they can be corrected.

The mainstay of treatment is to know the cause of the pain. If the cause is known, it can be corrected. The lower back pain in spina bifida can also be due to muscle problems. This kind of pain needs postural modification. Once this sort of situation has developed, it can only be treated by changing the sitting or standing posture [2].

  • Analgesic Agents

taking medication for spina bifida back pain relief

Different types of analgesic drugs can be used in the treatment of Spina Bifida back pain. The analgesic agent is selected depending upon its efficacy, adverse effects, and the severity of pain. In case of low to moderate levels of pain, simple analgesics are used (e.g., NSAIDs). In case of severe pain, opioids are used. The analgesic can be used orally, intramuscularly, or intravenously. For the most part, in low to moderate pain, the oral route is used. The intravenous route provides faster relief than the oral. [3] . However, there is a high risk of addiction, so patients need to be aware of this.

  • Surgical Interventions

The ultimate solution to spina bifida pain is surgical intervention; however, the patient may have to go through many surgical procedures, such as surgery for the drainage of nutritional fluid (CSF), because of overproduction. The patient may need surgery for tethered cord or for some other deformity. These surgical procedures are complicated, and the success ratio is low [1,4], but they can greatly reduce back pain.

  • Sleeping Chips

If the patient is experiencing pain and lack of sleep, they can look into using sleeping chips (CieAura holographic chips) that can be beneficial. These chips help the patient to have a peaceful sleep and are placed on the part of the body that hurts, as well as on the temple at night. These are coded chips and contain information that vibrates with the body cells. This has an effect similar to the effect music has on the mind [4].

  • Other forms of therapy 

There are many alternative forms of treatment that you can discuss with the primary care provider to determine if they are appropriate. These include:

  • Water therapy
  • Massage Therapy
  • Acupuncture
  • Yoga
  • Meditation or Feldenkreis
  • Music Therapy
  • Pet Therapy [8]



  1. CANNONE, J. (2011, June 30). SB and Back Pain: What to Consider.
  2. Outpatient Rehabilitation. (2022).
  3. Drug List- Analgesics and Anti-inflammatory Drugs Flashcards | Quizlet. (2022). Quizlet.
  4. Allen, T. (2014, May 6). Infant Massage for SB. EzineArticles; EzineArticles.
  5. 10 Upper & Lower SB Back Pain Causes & Relief Tips. (2013). SB Resource Center.
  6. Home Care Assistance of Oakville. (2016, December 23). Home Care Assistance Oakville.
  7. Low Back Pain Fact Sheet | National Institute of Neurological Disorders and Stroke. (2018).
  8. Pain – SB Association. (2021, October 6). SB Association.
  9. Cofano, G. P., Anderson, B. C., & Stumpff, E. R. (2014). Chiropractic care of acute low back pain and incidental SB occulta: a case report. Journal of chiropractic medicine, 13(4), 273–277.
  10. ‌SB: Types, Tests, Treatment & Prevention. (2020). Cleveland Clinic.
  11. Clinical Pain Advisor. (2019, January 19). Neurologic Complications of Neuraxial Analgesia/Anesthesia: Other. Clinical Pain Advisor.
  12. SB – Symptoms and causes. (2022). Mayo Clinic;
  13. Da Silva, L. F., Robin, S., Guégan-Massardier, E., Krzanowska, K., Mejjad, O., Vittecoq, O., & Le Loet, X. (1997). Peripheral neurological involvement as the first manifestation of SB occulta. Revue du rhumatisme (English ed.), 64(12), 839–842.
  14. ‌Sciatica – Symptoms and causes. (2020). Mayo Clinic;
  15. Cadman, B. (2018, February 27). What causes SB occulta?; Medical News Today.
  16. Can Chiropractic Help You Manage Your SB Occulta? – Holt Chiropractic & Massage Blog. (2018, October 19). Holt Chiropractic & Massage Blog.
  17. SB Occulta – SB Association. (2021, January 21). SB Association.


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