Early onset of disabling backache in acromegaly is infrequent. A case is presented of a young acromegalic with acute sacroiliac strain caused by improper occupational lifting, precipitated by the instability of joints due to hypersomatotropism and concomitant with lumbosacral facet tropism. The newly observed radiological feature of the acromegalic, hyperostosis of the spinous processes is believed to contribute to the aching in the low back. The patient resumed working after ten adjustments to the sacroiliac joint, supplemented with cryotherapy, sacral brace and postural education. It is postulated that backache in acromegalics is primarily related to acute accidental, or to chronic repeated, occupational or recreational microtraumas to the low back or to the hyperostosis of the lumbar spinous processes.
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