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Q: What is spondylosis, and how is it treated?

A: Spondylosis is common in young athletes and a common cause of lower back pain in children and adolescents. It is a crack or stress fracture (weakness) in one of the vertebrae, the small bones that make up the spinal column. Spondylosis can occur when there is repeated stress on the lower back, such as a lot of repetitive arching (bending) motions or twisting. Having a background in gymnastics, I had one of these injuries and know how it feels and how frustrating the recovery can be.

Although it can happen among young athletes of any age, we often see these injuries in teens. There are certain sports where it occurs more frequently, such as gymnastics and dance. But we also see them in sports like soccer, where athletes twist to kick the ball and volleyball, where athletes jump and twist to spike the ball. Those are just a few of the sports where spondylosis tends to be common. It’s something that physicians, coaches and parents should keep in mind. So, if a child is having back pain for longer than a month, it’s important to get them checked out for a spinal stress fracture.

For those patients who come to us and their (MRI) diagnostic imaging indicates they’ve got either the beginnings of or advanced spondylosis, treatment depends on the severity of the condition. Treatment differs mainly in the amount of time we spend allowing this part of the body to heal. It’s important to rest the back from repetitive arching or bending, as well as jumping and landing, which also puts strain on the back. You should rest it for a minimum of two to three months, even for a mild case; if it’s a more severe case, possibly closer to six months.

I have found that you do not necessarily have to brace the spine to allow it to rest. However, we sometimes see faster recovery with a brace because it limits mobility. Kids adapt very well to the brace. They find comfort in it, knowing that it will help them heal. They also appreciate that it clearly indicates to their coaches and teammates that they are injured. It’s a good reminder to their coaches to not push them and allow them to rest.

It’s important to catch this kind of injury early and treat it before the child develops a full fracture line. If we diagnose it when the bone is swollen, we can rest it and let it heal without ever breaking fully. This leaves the spine completely intact and less likely to cause issues later as an adult.

If a young athlete comes to us with the beginnings of spondylosis and wants to continue to compete as an athlete, we can get them started in physical therapy and core strengthening right away while they’re resting. We try to develop the muscles around the spine, including the trunk (shoulders, chest, lower abdomen, back and buttocks) muscles. In addition to general strengthening, we also look at form — the specific motions that the athlete might be doing that caused this injury. We want to improve their form so that the back doesn’t keep getting stressed.

If you have any concerns about back pain or other spine conditions, contact The Spine Center at Weill Cornell Medicine. We are happy to help you find the best treatment available.

This question was answered during the episode of Spine Time called “Back and Neck Conditions in Kids and Teens.” A recording of this webinar, held on December 15, 2021, is available on YouTube. To sign up for future episodes of Spine Time, where you can ask questions of our spine specialists, subscribe here.

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