Spondylolysis is an overuse condition of the lower back that is commonly seen in football players. It occurs from repetitive extension of the back, such as when linemen have to block and put their lower backs in extended positions. Spondylolysis is essentially a stress reaction, or even a stress fracture, of small parts of the vertebral bodies in the lumbar spine. It is not an uncommon injury in young athletes, such as high school football players, and as such, it is a common cause of low back pain in athletes.

Signs and symptoms of spondylolysis

Typically the athlete will complain of worsening pain in the lower back with sports. Occasionally it will get better with rest, but as the symptoms progress, even activities of daily living can be painful. The pain is usually in the middle of the lower back but occasionally it can be felt just off to either side. Rarely there is radiating pain down the leg. Typically there are no neurologic symptoms, such as numbness, tingling, or weakness. Examination by a sports medicine physician usually reveals pain with hyperextension of the lumbar spine. X-rays are usually very helpful, and oblique x-rays can often show the injury if it has progressed. Early in the process, however, x-rays can be negative. If the diagnosis is in question, the physician might order a bone scan or another test for this problem.

Treatment of this cause of back pain

Fortunately pain from spondylolysis improves without surgery. Usually it is helpful to hold the athlete out of sports that worsen the pain. When his pain decreases to the level that he can start physical therapy, rehabilitation focuses on strengthening and stretching the abdominal muscles, the lumbar spine muscles, and other core muscles. Return to sports can take several weeks to many months.

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