In the first of a two-part article, Chris Mallac looks at the lumbar spine disc herniation. What are the likely signs and symptoms associated with disc herniation, and what are the selection criteria for micro-discectomy surgery in athletes?
Great Britain’s Andy Murray holds his back in pain during French Open, 2009. Credit: Action Images / Scott Heavey Livepic
Low back pain is a reasonably common complaint in both the young college age athlete and professional athlete, and it has been estimated that more than 30% of athletes complain of back pain at least once in the career(1). The cohort of back injuries that can affect the athlete include disc degeneration, disc bulge/herniation, facet joint arthropathy, spondylosis , spondylolisthesis, muscle spasm and stress fractures.
Lumbar spine disc herniation is one type of lumbar injury that can not only cause debilitating low back pain, but can also compress nerve roots and create radicular referral of pain into the lower leg with associated sensation changes and muscle weakness. This injury will not only affect the short-term competition ability of the athlete, but may also reoccur and become chronic possibly resulting in a career ending injury. Managing disc herniation in the athlete usually begins with conservative treatment and if this fails, surgical options are considered. However, often elite athletes will request a faster resolution to their symptoms to minimise time away from competition. Therefore, providing the criteria for lumbar spine surgery are indicated, the conservative period will often be compressed, and surgery will be sought earlier. The favoured surgical procedure for the athlete with a disc herniation is the lumbar disc micro-discectomy.
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