Muscular strains
and ligament sprains
These can be from overuse, improper technique or body mechanics, poor
flexibility or conditioning, as well as direct trauma. The category
is often diagnosed by exclusion and the condition is typically self-limiting.
Spondylolysis
and Spondylolisthesis
The first is a defect in the bony ring of the spinal column or vertebra,
and the second is a slippage of one vertebra in relationship to another.
Frequently, these are found in athletes who do a lot of twisting or
hyperextension (bending backward) and can be mistaken for sprains or
strains.
Disc herniation
Though less common in the young athlete, high impact to the spine can
produce a tear in the annulus (outer covering of the disc) between
the vertebra, allowing the inner disc contents to protrude or extrude
and place inappropriate pressure on the spinal cord and/or nerve
roots. Often, there will be neurological symptoms, such as pain
that radiates into the buttocks or leg, numbness or tingling in
the leg, and/or weakness.
The older athlete
can have any of the above but is more susceptible to degenerative
diseases of the spine, chronic disc herniation and mechanical pain
due to weight-control problems.
When planning treatment
for low back pain, the overall goal should be to restore normal spine
function and encourage a safe and independent return to activity
through appropriate rehabilitation.
Treatment options
can include:
Exercise
A variety of exercise categories can include directional preference
activities, stabilization exercises, core strengthening, general
strengthening, aerobic conditioning, flexibility and posture exercises,
as well as sport-specific or simulation activities.
Manual Therapies
These include mobilization of the spine or careful manipulation for
select patients, as well as soft tissue techniques. The goal would
be to use these techniques in conjunction with other forms of exercise
and to discontinue their use over time to minimize a patient’s
dependence on them.
Supplemental
or Complementary Treatment
Practices can include heat or cold therapy, ultrasound and electrical
stimulation in many forms, biofeedback, traction or massage. Research
does not support these as providing the best treatment for low back
pain but can be used sparingly to supplement the first two categories.
Massage in particular
has been shown to provide more psychological than physiological relief.
Alternative treatments such as acupuncture are of benefit to some.
Doctors can provide epidural steroid injections or nerve blocks in
some cases where the pain is more severe and unresponsive to conservative
treatments.
Surgery
Surgery is rarely necessary in the management of acute low back pain
in athletes. In most circumstances, it is the selected form of
treatment only after a prolonged program of non-operative management
when it is evident that conservative treatment has failed.
Contact Us
The highly trained therapists at Memorial Hermann Sports Medicine are
ready to help guide the athlete with low back pain through their
rehabilitation process, including providing a comprehensive maintenance
program once function is restored.
Medical screening
by spine specialists who can rule out more serious conditions is
available along with appropriate referral to therapy, or you can
simply ask your primary care physician for such a referral. For
further information or to schedule an appointment, please contact
us in the Medical Center at
713-704-0777. |
