Back and Pelvic Pain in Older Athletes (Continued)

Between the ages of 14 and 34 years, 90 percent of the discs were found to be normal. At ages 35 to 45, degeneration was evident in 75 percent. After the age of 46, every single fifth lumbar disc was degenerated, and only 25 percent of the fourth lumbar discs were normal. This study showed that it is not the degenerated discs that cause low back pain. Many patients and athletes are distressed at being told that they are suffering from one or more degenerated discs. This suggests an irreversible and crippling phenomenon. The term "degenerated" should be discarded because disc degeneration is universal as age advances, and often causes no symptoms. There must be other structures in the back that are causing the athletes' symptoms. The structures causing athletes' back pain are most often the ligaments.

The low back is composed of muscles and ligaments. The posture is held erect by four particular sets of muscles. These muscles include the abdominal muscles, the back extensor muscles, and a set of paraspinal muscles that lie to the side of the vertebra. There are also important muscles that control hip, leg, and pelvic motion. The most important of these is the iliopsoas muscle. These muscles have a significant influence on the function of the back. The supraspinatus and interspinatus ligaments go from vertebra to vertebra. There are also strong ligaments that go from the vertebrae to the ilium (iliolumbar ligaments), along with the ilium to sacrum (the sacroiliac ligaments). Cumulative trauma through years of sports can result in small tears of these ligaments. One major trauma or injury can also be of such severity that healing never occurred. Since the ligaments do not heal, the intervertebral discs do not have the support that they need. This is why there is such a high degree of Degenerative Disc Disease in the lower back, which is essentially 100 percent by age 46. Degenerative discs are the result of ligament laxity or instability in the lumbar vertebral segments. The instability and ligament laxity cause the chronic low back pain and send athletes by the droves to chiropractors. Manipulation is helpful to realign the vertebrae, but does nothing to regenerate the damaged ligament. Prolotherapy must be given to repair the ligament tissue to allow the vertebrae to stay in place permanently.

In our opinion, Prolotherapy is the treatment of choice for treating low back pain in older athletes. Prolotherapy injections are typically given into the ligaments connecting the vertebra, along with injections into the ligaments between the ilium and sacrum. This helps to tighten the connections between the pelvis and lumbar spine and assists the muscles in providing stability to the back. It is amazing how many athletes end up avoiding surgery once they have Prolotherapy because Prolotherapy eliminates the pain and stabilizes the back.

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