Oh My Aching Back ... in Young Athletes

By: David L. Coran, MD

Lower back pain is a common complaint in teenagers and young adults. It’s not just for those athletes who have spent a lifetime of bending, moving, shoveling snow, and more.

According to a prospective study published in the Journal of Pediatric Orthopedics, up to 25 percent of adolescents evaluated by a doctor experience lower back problems. In high school athletes, the incidence of lower back pain approaches 40 percent in certain sports, according to the same paper. Most are self-limiting and result from “non-specific causes.” If back pain persists or frequently recurs, a primary care physician or an orthopedic specialist can diagnose specific causes.

Teenage athletes who participate in competitive sports which involve repetitive extension – such as bending backward – may develop stress injuries in their lumbar spine. These conditions include spondylolysis, or stress fractures, and spondylolisthesis or a forward slip of the spine.” Most cases can be treated by taking a break from the inciting activity, physical therapy, over-the-counter anti-inflammatories (NSAIDs) and bracing. Rarely is surgery considered. The option may be explored if the pain does not improve after six months.

If back pain is associated with pain, numbness or weakness radiating into the leg, a disk herniation should be evaluated. Persistent or progressive symptoms of radiculopathy may need additional evaluation through X-rays and an MRI. As with the previously cited conditions, surgery is rarely needed. Lumbar microdiskectomy surgery to remove a herniated disk is successful in over 90 percent of cases when non-operative treatment fails, according to The Journal of Joint and Bone Surgery.

Learn more about back conditions and treatments.