Jock Doc

Lower back pain in teenage athlete can mean a strain; MRI needed to diagnose

Q. My son is 16 and has had soreness in his lower back. He does not recall specifically injuring it but he was a lineman for the last football season for his high school. It is bothersome most when he works out. He went to the pediatrician and got X-rays, which did not show anything. He said that he should rest it and it would probably get better and so far, whenever he works out, it still hurts. Do you have any suggestions?

A. There are many causes of low back pain in a teenage athlete. Even if X-rays are normal, there could be a problem with the soft tissues or bones that show on the X-ray. It is common in football linemen, gymnasts and tennis players that hyper extend their spine to develop a stress fracture of the pars interarticularis, which is part of the vertebra of the lower back.

X-rays may not show this condition and an MRI scan, bone scan or CT scan may be necessary to accurately diagnose the condition. Other possible causes of lower back discomfort are strain of the sacroiliac joint, a herniated disk or paravertebral muscle strain. Most of these conditions will get better with rest and physical therapy and rehabilitation program. However, some of these conditions may require bracing or other treatment modalities. I recommend your son see an orthopedic surgeon or spine specialist so he can get better and return to his normal competitive lifestyle.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to