Bending Over Backwards: When Back Pain Signals a Fracture: A Pediatric Case Study
Presentation
A young female patient came to Thompson Chiropractic with low back pain that had started a week earlier and gradually worsened. There was no clear injury, no falls or impacts, but she was active in both dance and gymnastics. The pain was localized to a small area of the low back and worsened with forward bending, backward extension, running, and cartwheels. Rest brought some relief, but she was struggling to return to dance.
Examination
On exam, she showed an antalgic list, muscle spasm in the low back causing a visibly crooked posture as the body compensated for pain, along with notably tight hamstrings. Bending forward and backward reproduced her pain, as did rising onto her toes and dropping to her heels. Palpation was unremarkable at every level except L5, which was clearly tender.
Diagnostic Workup
Given the exam findings and her activity history, a stress fracture was suspected. No treatment was provided, she was referred to the ER with a specific request for oblique X-ray views, the best angle for catching a stress fracture in the vertebra.
Diagnosis & Outcome
Imaging confirmed a complete fracture at L5, a pars interarticularis fracture, pictured above showing what this looks like on an oblique view. She was referred out for medical management of the injury.
Key Takeaway
This injury, while rare, is most often seen in young athletes doing repetitive backward-extension movements, common in gymnastics and dance. The good news: most kids recover fully with no long-term issues. This isn't a reason to avoid these sports, the confidence, resilience, and physical benefits they build are well worth the risks.
Noticing back pain in your young athlete? Book a consultation with our clinic today.
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