Low back pain in young athletes

The incidence of back pain in the adult athlete is relatively common, however low back pain in the young athlete is a cause for concern because the potential causes differ from those in adults. Many back conditions are contributed to by a child’s immature skeleton. Children with low back pain should be listened to and carefully examined by a physician.

The most common causes of low back pain in children include stress fractures, muscle or tendon strains, and growth conditions. However more serious conditions including tumors need to be ruled out. A thorough history is important in making the diagnosis of low back pain. Symptoms involving pain down the legs are important to note. Night pain can be more worrisome.

Muscle or ligament strains of the low back are pretty common. The pain usually comes on after a specific event. The pain is usually worse with movement including bending forward. Treatment includes ice for the first 48 hours, rest from activities, and anti-inflammatories. Switch to heat and begin rehab exercises when the pain starts to resolve. Return to the specific sport when the athlete is pain free with motion.

Stress reactions or stress fractures (Spondyloslysis) are relatively common in young athletes especially in “back intensive” sports such as dance, gymnastics, weight lifting, and football. The stress fracture occurs in the bone joint between the vertebrae. Some children have a natural weakness in these joints from birth and are more susceptible to the fracture. Patients report pain on one or both sides of the low back that worsens with motion and running. The pain is usually worse with bending backward. Early treatment includes rest from sports activities and use of a brace with activities of daily living. As symptoms improve, a back stabilization exercise program is started. Return to sports requires full range of motion, pain free, and excellent strength in the back, usually taking 3-6 months.

Occasionally forward slipping of one vertebrae (Spondylolisthesis) can result becoming a chronic problem for the athlete. Patients with this problem can participate in sports with the proper back rehab program and hamstring stretching program.

Disk injuries, and vertebrae fracture are uncommon in young athletes. Children undergoing growth spurts commonly have tight hamstrings and back muscles that can cause low back pain. On rare occasions tumors or abdominal problems can present as back pain.

Young athletes with low back pain should be taken seriously and thoroughly examined by a physician. Most cases are treatable with proper rest and rehabilitation. Maintaining a regular stretching program will help prevent many back problems.