Why does my back pain return after physical activity?

Question

Hello doctor,

I am 18 years old. I am experiencing pain in the right side of the L5-S1 transverse process. A bone scan shows inflammation, but no micro-fractures are present. X-rays have returned negative, indicating no breaks. An MRI reveals trauma to the L5-S1 transverse process.

I can touch my toes and lean back without difficulty, but I experience pain when flexing the quadratus lumborum muscle. The discomfort is believed to be related to physical activity and becomes more intense with impact activities like running and jumping.

I have been dealing with this issue for two months. I was cleared to start exercising again, but three days later, the pain returned. I have since refrained from exercising for two months, and my back feels significantly better now.

I would like to understand the underlying problem and how I can resolve it.

Please guide me.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and understand your concern.

You are dealing with a stress fracture of the transverse process of your L5 vertebra. I understand this can be quite concerning, but this type of injury typically takes about 6 months to heal.

During this healing phase, it is really important to focus on your diet and make sure you are getting the right nutrients. Taking calcium and vitamin D supplements can be particularly beneficial.

I recommend you get your blood levels tested for a complete blood count (CBC), erythrocyte sedimentation rate (ESR), serum vitamin D, and serum vitamin B12. This will provide us with a clearer picture of your overall health and your healing progress.

For the supplement regimen, here is what you should do:

Start taking Calcium Carbonate 500 mg, one tablet, three times daily before meals, for the next three months.
For vitamin D, take a 60,000-unit tablet daily for 10 days, then switch to one tablet monthly for the next year.
Also, take 500 mg of Vitamin C, one tablet twice a day for one month before meals.

It is perfectly normal to start feeling better around the two-month mark, but please hold off on returning to sports for an additional two months to avoid any further issues. This advice is tailored to your situation, and I want to emphasize that it is based on the information provided. For a comprehensive understanding, we will need to correlate this with clinical findings and any test results you receive.

When you are ready, please come back with those blood reports for a follow-up. Until then, take care of yourself and remember to avoid any sports activities for the next couple of months.

Hope I have addressed all of your queries and concerns. Do follow up whenever needed.

Thank you.