eMedicine Specialties > Sports Medicine > Spine

Lumbosacral Disc Injuries: Follow-up

Author: Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM, President and Director, Georgia Pain Physicians, PC; Clinical Associate Professor, Department of Physical Medicine and Rehabilitation, Emory University School of Medicine
Coauthor(s): Kevin P Sullivan, MD, Consulting Staff, The Boston Spine Group; Erik D Hiester, DO, Fellow in Interventional Pain Management, Emory Medical School/Georgia Pain Physicians
Contributor Information and Disclosures

Updated: Jun 23, 2008

Follow-up

Return to Play

Return to play is an individualized process. No specific time frame exists for a particular injury. Safe return to play is allowed after the appropriate sport-specific rehabilitation program is completed and the athlete demonstrates full pain-free range of motion and proper neutral spine posture with sport-specific activities.

Related Medscape topic:
Resource Center Exercise and Sports Medicine

Complications

Complications of surgical intervention include bleeding, infection, nerve damage, chronic dural leak, and scar-tissue formation surrounding or compressing nervous tissue. Fortunately, these complications do not happen often, but when they do, they may cause the patient to be in worse shape than before having had surgery.

Prevention

Injury prevention is best accomplished through good coaching, proper techniques during sport-specific activities, adequate preparticipation training, and appropriate safety measures, including proper protective equipment and adherence to the rules of the game.

Education

Inform patients that the natural history of an acute radiculopathy suggests that most patients recover within several weeks to months and that surgery is generally not necessary. Educate patients regarding home program activities, which may be performed on a routine basis to help strengthen their spine and associated muscle groups that may help prevent injury in the future.

Miscellaneous

Medicolegal Pitfalls

  • Medicolegal pitfalls involved in lumbosacral disc injuries and spine care in general are similar to other areas of medicine. Delayed and incorrect diagnoses may lead to medicolegal problems. Through appropriate history and physical examination, indicators for inflammatory, infectious, traumatic, and oncologic disorders can be identified and evaluated in an expeditious manner. Further diagnostic testing is indicated when "red flags" are identified in the history and physical examination or when less than adequate recovery is achieved in an appropriate time frame.
  • Patient education and communication is an important part of limiting one's medicolegal problems. Studies have shown that poor patient-physician relations are a greater predictor of lawsuits than errant diagnoses.

Related Medscape topics:
Resource Center Medical Malpractice and Legal Issues
Resource Center Trauma
Specialty Site Hematology-Oncology
Specialty Site Infectious Diseases
Specialty Site Pathology & Lab Medicine

 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous coauthor Dr Dennis P White to the development and writing of this article.



More on Lumbosacral Disc Injuries

Overview: Lumbosacral Disc Injuries
Differential Diagnoses & Workup: Lumbosacral Disc Injuries
Treatment & Medication: Lumbosacral Disc Injuries
Follow-up: Lumbosacral Disc Injuries
References
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Further Reading

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Contributor Information and Disclosures

Author

Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM, President and Director, Georgia Pain Physicians, PC; Clinical Associate Professor, Department of Physical Medicine and Rehabilitation, Emory University School of Medicine
Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM is a member of the following medical societies: American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine, American Medical Association, International Association for the Study of Pain, Physiatric Association of Spine, Sports and Occupational Rehabilitation, and Texas Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Kevin P Sullivan, MD, Consulting Staff, The Boston Spine Group
Kevin P Sullivan, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine, Association of Academic Physiatrists, and Physiatric Association of Spine, Sports and Occupational Rehabilitation
Disclosure: Nothing to disclose.

Erik D Hiester, DO, Fellow in Interventional Pain Management, Emory Medical School/Georgia Pain Physicians
Erik D Hiester, DO is a member of the following medical societies: American Academy of Family Physicians, American Medical Association, American Osteopathic Association, and American Pain Society
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.

Managing Editor

Henry T Goitz, MD, Chief, Sports Medicine, Associate Professor, Department of Orthopaedic Surgery, Medical College of Ohio
Henry T Goitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons and American Orthopaedic Society for Sports Medicine
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

Craig C Young, MD, Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Sports Medicine Fellowship Director, Medical College of Wisconsin
Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, Phi Beta Kappa, and Wilderness Medical Society
Disclosure: Nothing to disclose.

 
 
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