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%.^[11]

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 following^[11]:

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, see eMedicineHealth's patient education articles Slipped Disk and Back Pain.

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Media Gallery

Radiograph of the lumbar spine. This image demonstrates L5-S1 disk space narrowing (the most common location).
Magnetic resonance image of the lumbar spine. This image demonstrates a herniated nucleus pulposus at multiple levels.

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Author

Luis E Palacio, MD Director of Primary Care Sports Medicine, Northern Nevada Medical Group

Luis E Palacio, 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

Disclosure: Nothing to disclose.

Coauthor(s)

Jeffrey W R Dassel, MD Associate Director, Sports Medicine and Faculty, Department of Family and Community Medicine, Christiana Care Health System

Jeffrey W R Dassel, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Family Physicians, American Medical Society for Sports Medicine, Society of Teachers of Family Medicine

Disclosure: Nothing to disclose.

Annie Collier, MD Staff Physician, Department of Emergency Medicine, Lincoln Medical Center, Cornell University School of Medicine

Annie Collier, MD is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Sherwin SW Ho, MD Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago Division of the Biological Sciences, The Pritzker School of Medicine

Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Arthroscopy Association of North America, Herodicus Society, American Orthopaedic Society for Sports Medicine

Disclosure: Received consulting fee from Biomet, Inc. for speaking and teaching; Received grant/research funds from Smith and Nephew for fellowship funding; Received grant/research funds from DJ Ortho for course funding; Received grant/research funds from Athletico Physical Therapy for course, research funding; Received royalty from Biomet, Inc. for consulting.

Additional Contributors

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, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Acknowledgements

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.