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- Wed Aug 16, 2006 11:45 am
My 17 year old son started having lower back pain 5 months ago. He is 6'1" and is a basketball player. He has been diagnosed with a pars defect bilateral and a degenerative disc of the L5. He has not had surgery and is currently undergoing PT. Of significant note, he has extremely tight hamstrings, making bending and flexing a problem. He now has periodic pain/numbness in his legs. The pain is sporadic; does not occur daily or on the same side. It occurs in one or both legs. It happens freguently when driving, but has also occured when sitting or standing. A second MRI does not show compression of the nerves. Could this new symptom be indiciative of an underlying systemic problem or a normal symptom of his condition? At what point do we become concerned that the disc is progressing? Please advise. He's wanting to play varsity basketball this season and has been given the ok if he can tolerate the pain.
| Dr. Safaa Mahmoud
- Thu Aug 17, 2006 1:03 pm
Not all individuals with degenerative disc lesions have symptoms. Athletes like basket ball players are more likely to have symptoms at some time as certain back movements can exacerbate any existing back problem.
In most of the cases the primary cause is muscle spasm. An associated Muscle spasm alone can cause or aggravate the pain due to disc lesions.
Physical therapy, certain exercises, epidural steroid injections, non-steroidal anti-inflammatory medications, and regulating daily activities during pain period are the main approaches to control the pain non surgically.
The effect of treatment may be gradual but clear and periods of acute pain may last for 3 month.
Surgery for disc herniation is only considered if symptoms are not controlled after at least one month (6 weeks) of medical and conservative treatment, or in very complicated cases with serious symptoms.
MRI results are very important in the diagnosis of vertebral changes, but the clinical picture, I mean the complaints and the physical examination are more important to determine the management approach.