eMedicine Specialties > Sports Medicine > Spine

Lumbar Disk Problems in the Athlete: Follow-up

Author: Luis E Palacio, MD, Director of Primary Care Sports Medicine, Department of Family and Community Medicine, Tufts University School of Medicine; Residency Faculty, Tufts University Family Medicine Residency/Cambridge Health Alliance
Coauthor(s): Jeffrey W R Dassel, MD, Sports Medicine Coordinator and Family Medicine Practitioner, Westside Health Center; Annie Collier, MD, Staff Physician, Department of Emergency Medicine, Our Lady of Mercy Medical Center; John Munyak, MD, Associate Program Director, Director of Sports Medicine Education, Department of Emergency Medicine, Lincoln Medical and Mental Health Center
Contributor Information and Disclosures

Updated: Oct 12, 2007

Follow-up

Return to Play

Percutaneous discectomy requires at least 2-3 months of postoperative rest.
 
Microdiscectomy requires 6-8 weeks of rest for noncontact sports, and at least 3 months of rest (typically 4-6 months) for contact sports. Athletes are less likely to return to play when multiple disc levels are affected. Return to play for single-level microdiscectomy has been reported to be 90%.10
 
Return to play after spinal fusion is controversial. Some authors suggest no return to play at the professional or collegiate level for contact sports after spinal fusion. Others utilize criteria for return to contact sports to include the following10 :

  • At least 1 year following surgery
  • Evidence of solid fusion
  • Resolution of pain
  • Full strength
  • Pain-free ROM
  • Full endurance

Complications

Complications of lumbar disc problems include prolonged or permanent nerve symptoms, chronic pain, and inability to return to sports.

Prevention

Avoidance of injury can be achieved through proper education, use of proper body mechanics, and appropriate stretching and strengthening exercises. Smoking cessation, weight control, and maintaining an active lifestyle can also be helpful.

Prognosis

95% of athletes have symptom resolution within 4 weeks, and 95% of those with lumbar disc problems return to play fully recovered.

A history of LBP is the greatest predictor for future episodes by up to a 3-fold increased risk; active LBP increases the risk of recurrence by 6 fold.

Education

Coaches, trainers, gym classes, pamphlets, and team and/or primary care physicians should provide education on how to avoid lumbar disk injuries.

For excellent patient education resources, visit eMedicine's Back, Ribs, Neck, and Head Center and Bone Health Center. Also, see eMedicine's patient education articles Slipped Disk and Back Pain.

Miscellaneous

Medicolegal Pitfalls

Failure to diagnose patients who present with red flags can result in severe neurologic deficits, paralysis, or death (see History).

Special Concerns

Patients younger than age 20 years or older than age 50 years are more likely to present with a serious cause of lumbar disc problems, such as a tumor or infection; therefore, more a extensive workup is usually indicated in these populations.

Pediatric patients have a higher incidence of congenital, developmental, and bony abnormalities. Geriatric patients have a higher likelihood of life-threatening causes, including a rupturing intra-abdominal aortic aneurism, vertebral fracture, metastatic cancer, pancreatitis, and other intra-abdominal pathology.

 


More on Lumbar Disk Problems in the Athlete

Overview: Lumbar Disk Problems in the Athlete
Differential Diagnoses & Workup: Lumbar Disk Problems in the Athlete
Treatment & Medication: Lumbar Disk Problems in the Athlete
Follow-up: Lumbar Disk Problems in the Athlete
Multimedia: Lumbar Disk Problems in the Athlete
References
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References

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Further Reading

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Keywords

athletes and back pain, low back pain and sports, strained back, back is out, herniated disc, slipped disc, herniated nucleus pulposus, HNP, ruptured disc, degenerative disc disease, DDD, lumbago, mechanical low back pain, LBP, lumbar disc problems

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Contributor Information and Disclosures

Author

Luis E Palacio, MD, Director of Primary Care Sports Medicine, Department of Family and Community Medicine, Tufts University School of Medicine; Residency Faculty, Tufts University Family Medicine Residency/Cambridge Health Alliance
Luis E Palacio, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, and American Medical Society for Sports Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Jeffrey W R Dassel, MD, Sports Medicine Coordinator and Family Medicine Practitioner, Westside Health Center
Jeffrey W R Dassel, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Family Physicians, American Medical Association, and American Medical Society for Sports Medicine
Disclosure: Nothing to disclose.

Annie Collier, MD, Staff Physician, Department of Emergency Medicine, Our Lady of Mercy Medical Center
Annie Collier, MD is a member of the following medical societies: American College of Emergency Physicians
Disclosure: Nothing to disclose.

John Munyak, MD, Associate Program Director, Director of Sports Medicine Education, Department of Emergency Medicine, Lincoln Medical and Mental Health Center
Disclosure: Nothing to disclose.

Medical Editor

Andrew D Perron, MD, Residency Director, Department of Emergency Medicine, Maine Medical Center
Andrew D Perron, MD is a member of the following medical societies: American College of Emergency Physicians, American College of Sports Medicine, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

CME Editor

Jon B Whitehurst, MD, Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner and Executive Board Member, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital
Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD, Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago
Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

 
 
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