Surgery should be a last resort for 3 common conditions, orthopedic expert says
FRIDAY, July 14, 2017 (HealthDay News) -- Back injuries are common, especially among competitive athletes.
Nearly 1 in 3 athletes playing professional or varsity-level sports experiences a back injury, a research review finds.
"Competitive players stress their lumbar [lower] spine for hundreds of hours a month, thereby predisposing themselves to specific injuries that should be recognized by health care practitioners," said lead author Dr. Wellington Hsu, an orthopedic spine surgeon at Northwestern Memorial Hospital in Chicago.
The human spine has 24 bones, or vertebrae. They're stacked on top of each other, separated by flat, round cushioning disks. When people walk or run, these disks absorb shock, the authors explained.
Athletes are at risk for problems involving their back bones and discs, particularly if they start intense training regimens when they are between 10 and 24 years old, the researchers noted.
One common problem for these young athletes is known as symptomatic lumbar disk degeneration. People with this condition have deterioration in a disk, resulting in a smaller space between the bones of the spine.
In extreme cases, this condition is treated surgically. But the review authors said there is little evidence supporting the success of this procedure among athletes.
Elite athletes between 20 and 35 years old may be at greater risk for another painful back problem known as lumbar disk herniation, the researchers warned. This occurs when the soft center of a disk pushes through its exterior due to wear and tear, or a sudden injury.
Generally, this condition improves within six weeks, and 8 out of 10 elite athletes are able return to their sport without surgery, the review found.
Young gymnasts, wrestlers, weightlifters and divers are at particularly high risk for a condition called spondylolysis, a stress fracture, the authors said.
This occurs when a small connecting bone in the lower back breaks, which could cause a spinal bone to disconnect and slip forward.
Others prone to lower back injuries are athletes of all ages who lift heavy weights without supervision or without lower back protection while training for extreme sports, the researchers added.
The review appears in the July issue of the Journal of the American Academy of Orthopedic Surgeons.
Surgery should be a last resort for athletes with lower back issues, said Hsu. He pointed out that rehab success rates are high for back injuries.
Nonsurgical treatment for pain may include medication and psychological counseling. Physical therapy can also help athletes gain flexibility and strengthen their core and back muscles.
"Expectations regarding surgical outcomes should be tailored for elite athletes depending on sport, and to sport-specific demands," Hsu said in a journal news release.
Recovery time depends on the sport and its physical demands, the researchers said. They cautioned that players should be assessed individually following a rehab program to determine if they are ready to return to their sport.
The U.S. National Institute of Neurological Disorders and Stroke provides more information on lower back pain (https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet ).
SOURCE: American Academy of Orthopedic Surgeons, news release, July 5, 2017