Is your child or teen experiencing lower back pain that worsens when they play sports?
A condition called spondylolysis may be the cause. Spondylolysis is a defect or stress fracture in the vertebra. It is a common cause of lower back pain in athletic children and teens. Kids are particularly at risk if they are participating in sporting activities that strain the lower back, such as elite gymnastics or cricket.
What is spondylolysis?
Spondylolysis is a stress fracture in the pars interarticularis. The term comes from the Greek words ‘spondylos’ (vertebra) and ‘lysis’ (loosening). The pars interarticularis is the small, narrow bit of bone in the back of the vertebra. It connects the upper and lower facet joints. As the weakest part of the vertebra, it is prone to injury from repetitive load and stress.
Spondylolsis most commonly occurs in the lumbar spine, or lower back, in the fourth or fifth vertebra. Fracture can occur on one or both sides of the bone. If the fractured pars interarticularis separates, it can cause the injured vertebrae to slip forward. This is known as spondylolisthesis.
What causes spondylolysis?
The cause of spondylolysis has not been established; however it most commonly occurs in athletic children and teens. There is an increased risk of occurrence in adolescents who play sports that strain the lower back, such as cricket, gymnastics, soccer, football, weightlifting, ballet and volleyball. Activities that involve repetitive over-extension or excessive load of the lower back contribute to spondylolysis.
What are the symptoms of spondylolysis?
Many cases of spondylolysis are asymptomatic or mild, which can make it difficult to detect.
If your child is experiencing lower back pain that gets much worse when they participate in sport, spondylolysis could be to blame. When symptomatic, pain may be experienced as a deep, dull ache in the lower back - like a muscle strain. It often radiates into the glutes and hamstrings. The pain is generally aggravated by specific sporting activities and reduces with rest.
If the condition progresses to spondylolisthesis, symptoms may be more pronounced and could include muscle spasms and tightness in the hamstrings and back. In severe cases, the vertebra may slip and pressure the spinal nerve root, causing numbness, tingling and weakness in the legs. This is a less common presentation, but it is important to know that if left untreated, spondylolysis can progress on to this.
How is spondylolysis treated?
How spondylolysis is treated by your child’s healthcare provider, will depend on the severity of symptoms.
Treatment for spondylolysis may include:
● Modifying or reducing the aggravating sporting activities for a period of time, to allow the spine to recover.
● Pain medication, as directed by your child’s healthcare provider.
● Use of a brace to support the lower back while it heals.
● Stretching and controlled exercise to increase mobility.
● In some circumstances, surgery may be considered, particularly if the fracture does not heal after 6 months of non-surgical treatment.
How can your chiropractor help with spondylolysis?
Chiropractic treatment can help to address back pain that is associated with spondylolysis and spondylolisthesis. The aim of chiropractic treatment is to improve spinal mechanics, enhance function, and improve posture.
A chiropractor will assess your child’s spine and determine any mechanical issues that are contributing to their pain. They may use specific spinal adjustment techniques in other areas of the spine to relieve lower back pain and restore motion in the area. Manual therapies may also be used to treat soft tissue issues including tight muscles that are restricting mobility and exacerbating the problem.
If your child is experiencing back pain, we’re here to help! Give us a call on 0413 v774 399 or email claire.chittleborough2@gmail.com and we’ll book you in for an appointment.