Sports Medicine: Spinous Process Apophysitis
Spinous process apophysitis is an injury to an apophysis in the low back. An apophysis is a growth plate at the end of a bone where a muscle, ligament, or tendon is attached.
What is Spinous Process Apophysitis?
Spinous process apophysitis is an injury to an apophysis in the low back. An apophysis is a growth plate at the end of a bone where a muscle, ligament, or tendon is attached. The spinous process is the back part of your spine that you can feel under the skin.
What Are the Signs & Symptoms
- back pain in the middle of the low back
- pain that is worse with arching backwards
- tenderness at the spinous process point
Increased Risk
- having an increased lordotic curve (sway back) in lumbar spine
- sports that require hyperextension of the back over and over (gymnastics, dance)
- starting dance or gymnastics at a young age
- poor physical conditioning, especially with differences in strength, flexibility, and neuromuscular control
How is Spinous Process Apophysitis Treated?
- Medicine
- Anti-inflammatory medicines like ibuprofen (Motrin® or Advil®) or naproxen (Aleve®) may be recommended. Take these as directed by your health care provider.
- Other minor pain relievers like acetaminophen (Tylenol®).
- Use of cold and heat
- Cold should be applied for 10 to 15 minutes every 2 to 3 hours for swelling and after any activity that makes symptoms worse. Use ice packs or an ice massage.
- Heat may be used before stretching and strengthening activities prescribed by
your health care provider or athletic trainer. Use a heat pack or warm soak. Apply
for 10 to 15 minutes.
- Taking a break from painful activity for a few weeks can reduce pain and let the injury heal.
- Elastic lumbar corset
- A soft brace called a lumbar corset may be used along with rest to relieve pain.
- Exercises
- Exercises to improve strength and flexibility may be suggested when the pain starts to go away to help learn proper back mechanics. These can be done at home, but your health care provider may make a referral to a physical therapist or athletic trainer.
How To Prevent
- Use proper technique.
- Do correct warm-up and stretching before practice or competition.
- Maintain correct conditioning, back and hamstring flexibility, back strength and endurance, and cardiovascular fitness.
When To Call the Doctor
Call your health care provider or the Sports Medicine team at (614) 355-6000 if:
- symptoms get worse after 2 to 4 weeks, even with treatment
- you have numbness, weakness, or loss of bowel or bladder function
- new, unexplained symptoms develop
Helping Hands Patient Education Materials
Written and illustrated by medical, nursing and allied health professionals at Nationwide Children's Hospital, Helping Hand instructions are intended as a supplement to verbal instructions provided by a medical professional. The information is periodically reviewed and revised to reflect our current practice. However, Nationwide Children's Hospital is not responsible for any consequences resulting from the use or misuse of the information in the Helping Hands.
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