The Hows and Whys of Back Pain in Young People. Alex Levchenko, DO Interventional Physiatrist October 22, 2017

Size: px

Start display at page:

Download "The Hows and Whys of Back Pain in Young People. Alex Levchenko, DO Interventional Physiatrist October 22, 2017"

Nickolas Wilkins
6 years ago
Views:

1 The Hows and Whys of Back Pain in Young People Alex Levchenko, DO Interventional Physiatrist October 22, 2017

3 Basics of back pain Relatively common Acute (2-4 weeks duration) Chronic (>13 weeks) Less common in under 10 years old Often musculoskeletal and self-limiting Affect 10-15% of young athletes More common in football, figure skating, gymnastics and soccer

4 Risk factors Overinvolvement in physical activities Improper training: Starting at early age Longer duration of training Excessive training Poor technique: Improper lifting techniques in weight lifting, ballet and figure skating Twisting motions in tennis and golf can cause strains and sprains

5 Risk factors Sedentary lifestyle Carrying heavy backpacks Computer and TV use Overweight Chronic poor posture Psychological issues and stress

6 Risk factors Growth spurts: Muscle imbalance Inflexibility Developing spine is susceptible: Compression Distraction Torsion injuries

7 Sports and back pain Football Basketball Cheerleading Dancing Diving Gymnastics Ice hockey Racquet sports Rowing Rugby Running Weight lifting Wrestling

8 Causes of back pain Strains and Sprains and muscle contusions Fractures including spondylolysis Disk herniations Postural Psychosomatic Thoracolumbar Scheuermann disease Lumbarization or sacralization Spina bifida Facet joint syndrome Tumors SIJ pain

9 Causes of back pain Apendicitis Pancreatitis Pyelonephritis Renal stones UTI Pelvic inflammatory disease Leukemia Inflammatory bowel disease Rheumatoid Metabolic Neuromuscular disease Myopathy

10 Causes of back pain If the pain is severe Accident or injury Pain has lasted longer than one month Neurologic deficits (weakness or numbness) Bowel or bladder changes Fever, rash, other joint pain, loss of appetite and weight loss, night pain Do not delay seeing a doctor!

11 Back pain in a young athlete Soft tissue sprains, strains and muscle contusions Lumbar spondylolysis Spondylolisthesis Disc herniation SIJ pain

13 Sprains, strains and muscle contusions Most common back injury Absolute bed rest is not recommended Daily activities as tolerated Analgesics and muscle relaxants Back rehabilitation program Full recovery within a few days to a few weeks but could take up to two months with sprains and overuse injuries

$Lumbar spondylolysis Common condition Stress fracture of pars interarticularis Ballet, dance, gymnastics, figure$

14 Lumbar spondylolysis Common condition Stress fracture of pars interarticularis Ballet, dance, gymnastics, figure skating, cheerleaders, football, weight lifting, wrestling, diving, volleyball Pain in the lower back without leg pain

15 Lumbar spondylolysis Rehab is focused on core and flexibility training Return to sports once pain free following rehab and being cleared by a physician May take 4-8 weeks to 3-6 moths to return to play

16 Lumbar spondylolisthesis Common complication of bilateral spondylolysis Aching pain in the lower back, buttocks and posterior thighs Young athletes have to be followed regularly Similar treatment as in spondylolysis Return to play in 4-6 months

17 Disk herniation Relatively rare in children Weight lifting, gymnastics, wrestling and collision sports Back and leg pain Relative rest, restriction from sports, NSAIDs PT Treatment 6-12 weeks with return to play in 3-6 months Excellent prognosis

18 Sacroiliac joint pain Buttock pain Rowing and cross country skiing Relative rest Modification of activities NSAIDs PT

19 Goals of rehabilitation Regain pain free ROM Improve core strength and stability Correct abnormal posture Improve biomechanics Improve sport techniques

20 Prevention Recognition of risk factors Improper technique Muscle imbalances/inflexebilities Training should be reduced during rapid growth Core strengthening Hamstring and hip flexor stretches Adequate sleep and rest

21 Return to play Specific to the diagnosis, sport/activity, age and maturity Once pain-free ROM and normal strength has been obtained

22 THANK YOU FOR YOUR TIME AND ATTENTION!

The Athlete s Lumbar Spine: Current Concepts

The Athlete s Lumbar Spine: Current Concepts Content / Objectives Anatomy Common injuries Treatment and prevention Pablo Vazquez Seoane, M.D. 44 th Annual Sports Medicine Symposium January 19 21, 2017