Treatment of multiple lumbar disk herniations in an adolescent athlete utilizing flexion distraction and rotational manipulation

Abstract

An acute case of low back pain in a high school athlete is described. Onset of nonradicular back pain was related to "squat-type" weightlifting in preparation for high school football. Magnetic resonance images demonstrated central posterior disk herniations with thecal sac effacement of the lower three disk levels. Clinical and electrophysiological evaluation revealed no neurological deficits. Flexion distraction and rotational manipulation with adjunctive paraspinal muscle stimulation resulted in early improvement and apparent long-term resolution of this patient's symptoms. The effectiveness of flexion distraction and rotational manipulation in reducing subjective symptoms are compared utilizing visual analog pain scales. Literature review of the conservative treatment of lumbar disk herniations is discussed.