Thoracolumbar syndrome in athletes

The thoracolumbar syndrome is a potential cause of back pain in athletes whose sport involves prolonged posturing with the hips flexed and the head extended upward. This syndrome may be overlooked and athletes are sometimes inappropriately treated for an incidental finding in the lower lumbar spine disclosed on conventional imaging studies. The clinical presentation involves point tenderness over the affected motion segment (T12 through L3) with pain radiating along a segmental nerve distribution (anterior or posterior rami divisions) of thoracolumbar origin. Provocative injection of the posterior joints and/or discs under image-intensifier-control can provide a definitive diagnosis. Muscle balancing and stabilization exercises to counteract the postural inequities inherent to the sport usually allow for successful return to play.