By Dev K. Mishra, M.D.
President, Sideline Sports Doc
- A recent study shows that low back pain is the third most common injury complaint for young athletes, ranking behind knee and ankle injury
- A “pop” or “snap” associated with immediate pain signals a possible significant injury and should be evaluated immediately in the nearest emergency department
- Any neurologic symptoms such as pain radiating down the leg, numbness, or tingling may signal a significant injury and should be evaluated urgently
- Mild to moderate low back pain that lasts two weeks should also be evaluated by a qualified physician
Low back pain is a common complaint amongst the young patients I see in my orthopedic practice. Most of the time the problem is a muscle strain that can be resolved with appropriate rest and rehabilitation. Occasionally, however, low back pain can signal a more serious condition such as a stress fracture or disc injury.
Dr. Neeru Jayanthi from the Loyola Strich School of Medicine and colleagues performed a large study of 1,206 participants who were between 8 years and 18 years old. The study followed 837 participants with 859 unique injuries and 360 uninjured participants who acted as controls. Low back injuries accounted for 127 injuries. Overall, 39% of the back injuries were serious, including stress fractures and complications of stress fractures.
I find that certain sports, typically involving spinal twisting and/or hyperextension place the young athlete at risk. This would include sports such as gymnastics, diving, lacrosse, tennis, and baseball pitchers. A second risk factor is improper form in weight lifting. And the study by Dr. Jayanthi also pointed to excessive hours of participation in a single sport as another risk factor.
When To See A Physician
There are two broad situations in which it would be important to seek qualified medical care. First, if there is concern for a serious acute spinal injury, and secondly, for low back pain that is lingering without improvement.
If a young athlete is on the field of play and has a sudden onset of significant pain, this is a sign of a potential serious spinal injury and should be evaluated urgently in the nearest emergency department. In almost all of these instances you will want to have the athlete lie still on the field of play without moving him/her, call for emergency transport, try to keep the athlete calm, and stay with them until emergency transport arrives. An athlete in this situation will have sudden onset of significant pain, they may have heard or felt a “pop”, and there may be complaints of pain radiating down the leg, or numbness and tingling.
In the second situation there may be mild to moderate low back discomfort that persists for days or up to a couple of weeks. The pain may be significant enough to cause the athlete to skip practices or games. In this case there could be an underlying significant cause for the pain, and a qualified physician should also evaluate these. Stress fractures in the spine can be successfully treated if caught early but stress fractures that are untreated can lead to a lifetime of low back issues that can drastically affect quality of life.