Adolescents involved in sports can develop back pain; a common cause of this back pain is the development of stress fractures (spondylosis) which can cause one vertebrae to ‘slip’ forward on the vertebrae beneath it (spondylolisthesis). This is most commonly seen in adolescents who engage in sports involving repeated hyperextension such as gymnastics or aspiring fast bowlers in cricket.
Interestingly, these fractures are thought to be present at birth (congenital) and diagnosed in adolescents who become symptomatic. Raising a fascinating question? How many adolescents have stress fractures (spondylosis) with or without ‘forward slippage’ (spondylolisthesis) that are never identified as they are never aggravated and become symptomatic? Unfortunately, this question is difficult to measure without a research study involving a large sample size.
So what should parents know?
Adolescents are at a greater risk of developing pain if they engage in sports involving hyperextension. Activities such as fast bowling in cricket, gymnasts and javelin throwing are all high risk sports and parents with children engaged in these activities should be aware of the potential for adolescent spondylolisthesis.
Symptoms frequently present when activity levels increase.
In many sports, talented individuals are identified in their teens and there is a sharp increase if the magnitude of their training demands. This period frequently coincides with the development of pain and subsequent diagnosis of adolescent spondylolisthesis. Adolescent athletes need to be carefully managed and monitored during this period to ensure no long term damage is done to their rapidly developing body.
What are the symptoms of spondylolisthesis?
Symptoms can vary between adolescents depending on the severity of the stress fracture and the resultant displacement. However, the development of persistent low-grade low back pain and/or episodes of acute low back pain with a ‘sharp or grabbing’ quality are common presenting complaints associated with spondylolisthesis.
What should I do if my child develops the symptoms of spondylolisthesis?
Some degree of low grade aches and pains are perfectly normal amongst active adolescents. However, if your adolescent develops the symptoms of spondylolisthesis you should seek a professional opinion.
Can the problem get worse?
In most cases spondylolisthesis is not progressive, and therefore, conservative management (such as Chiropractic) and revision of the activity levels of the adolescent is appropriate. However, a very small group of adolescents may develop more sever amounts of ‘forward slippage’ which may be graded from 1 – 5 on a defined scale. In these cases, where the spine has become unstable or where intractable pain is present, surgery may be considered.