This is an unusual case of spinal stenosis in a young athlete. Spinal stenosis is often found in older individuals, so hearing this story really caught my attention. Younger athletes often have spine-related conditions associated with herniated and bulging discs, muscle spasms, sciatica, piriformis syndrome and facet syndrome. That being said, younger individuals and athletes can suffer from this condition, which can cause extensive lower back and leg pain.
In advanced cases, spinal stenosis can cause balance problems, tingling, numbness, weakness in the lower extremities and loss of sensation. Unfortunately, in cases of true “classic” stenosis, the remedy is often surgery to open up the area where the nerves pass through, called the intervertebral foramen.
One of the chief reasons this opening (the intervertebral foramen) gets narrowed is a loss of lumbar disc height, resulting from a loss of water content. Typically, patients who suffer from lumbar spinal stenosis feel better in positions that flex the back and open up the space around the nerves, like sitting or bending forward. Activities like standing, walking or reaching overhead may increase lower back and leg pain, tingling and numbness.
What can be done for persons with spinal stenosis?
The first line of defense should be conservative treatment (like physical therapy) by someone who specializes in spine-related problems. A McKenzie evaluation will often be able to detect if certain movements will trigger spinal stenosis symptoms and guide the patient toward the safest and most appropriate exercises for your lower back condition. In some cases, lumbar stenosis is apparent on an x-ray or MRI but the patient’s evaluation by a physical therapist or doctor indicates another source of the problem. The key to a proper diagnosis is the pairing of a good history of the problem, clinical evaluation and imaging when indicated. David Wright has probably gone through all of this with the Mets medical team prior to stopping his career in baseball.
During the course of a physical therapy evaluation, it isn’t unusual to be prescribed anti-inflammatories while receiving care. If unsuccessful, the next step is often injections in the region of the lumbar spine that is the source of pain. In extreme cases, surgery is required to increase the area around the nerves that are pinched. In most cases of injections and spinal surgery, the goal is to abolish the symptoms in the lower extremities. However, back symptoms often may remain.
The intense demands of professional sports and the frequency of these positions that can trigger stenosis like in David Wright’s situation can make even modest stenosis appear more severe. In certain professions, like carpentry, workers have greater than average periods of time when in standing or lumbar extension, which can trigger any underlying stenosis more so than persons who are deskbound for most of their day.
David Wright may be able to manage his lumbar stenosis through conservative methods when the high demands of baseball and the need for peak performance are no longer part of his daily routine. We wish him luck in his recovery!