Management of Sports-Related Lumbar Conditions

Although low-back pain is common in the general population, there are unique considerations when athletes present with this complaint. The most common etiologies include degenerative disc disease, lumbar disc herniation, and spondylolysis. Genetic predisposition has recently been identified as a predominant determinant of degenerative disc disease but the intense physical loading and training demands of elite athletes may play a more significant role in athletes than in the general population. The evidence-based literature regarding lumbar disc herniation in athletes suggests that despite having career-ending potential, it would be reasonable for athletes to expect excellent clinical outcomes after both operative and nonoperative management. Spondylolysis, especially common in adolescent athletes, can often be successfully managed conservatively. If necessary, operative management with fusion or direct pars repair, combined with strict postoperative rehabilitation, can lead to successful return to sport.