Monday, November 11, 2013
The shelf life of an NFL running back is much too short. The body is asked to absorb repeated hits and that is coupled with turf that is unforgiving on knees and ankles. The career life expectancy of an NFL player is about 6 years but running backs may or may not last that long. Last month, Houston Texan Arian Foster made news by offering fans the opportunity to buy shares in his future earnings, but that was forever ago and now his stock is dropping because of planned season ending back surgery for a bulging disc.
Mr. Foster joins the 40% of the American population who suffer from low back pain. Most often it is because of a pulled muscle and the pain resolves with a little time and TLC. But sometimes, the cause of the pain is damage to one of the structural elements of the back and surgery may be required. It is rare that surgery is emergent and often, an operation is planned when other options like physical therapy, chiropractic care and medication injections fail.
The spine is made up of stacked vertebrae that are supported by muscles and ligaments. In between the bones lay the discs that act as shock absorbers to cushion the force of walking, running, jumping and twisting. The vertebrae also protect the spinal cord and the nerves that enter and leave, transmitting signals to and from the brain. Over time, because of age or due to trauma, the spine can degenerate and arthritis can set in, limiting the function of the back to move and to absorb the shocks of daily life. This may cause the muscles and ligaments to become inflamed but it can also cause the discs to bulge or rupture.
While the damaged disc can cause pain because of the local inflammation of the injury, the potential complication is that the disc can irritate a nerve root as it leaves the spine. In the lumbar spine, the low back, these nerve roots come together to form the sciatic nerve and the pain can radiate into the buttock and down the leg causing significant distress. The disc can also bulge and press back into the spinal canal where the cord is located and press on the cord, causing the pain and numbness to be felt in both legs.
The initial treatment remains the same for most patients but when muscles begin to weaken or reflexes are lost, an urgency exists to consider surgery to relieve the pressure on the nerve root or spinal cord. This progresses to a true emergency if the ability to urinate is lost and the patient becomes incontinent of stool, a condition known as cauda equine surgery, and if there is hope for the spinal cord, surgery needs to be done within hours.
Arian Foster’s medical course seems to be following the urgent, non-emergent course. His back pain has been diagnosed as a bulging disc and he is seeking opinions as to when it is best to have an operation. He may opt to have surgery sooner than later because he is reaching the halfway point of his NFL career and may not want to spend months waiting to see if therapy may work. Add to the equation is that his job is not sitting at a desk or standing in front of a classroom, it is being hit by 300 pound linemen who do not care that he has a fragile low back.
For most people, ice, heat, over the counter anti-inflammatory medications and activity as tolerated is the mantra to healing low back pain. Better yet is maintaining good back health by keeping weight under control, working on abdomen and back core strength, stretching to maximize flexibility and using proper lifting techniques. Unfortunately for Mr. Foster, he and his running back fraternity, are not like most people.
Illustration attribution: webmd.com, denverchiropractor.comThis entry was tagged arian foster, bulging disc, low back pain, sciatica
Dr. Wedro weighs in
“The difference between doctors who look after mere mortals and those who look after elite athletes may have to do with how many tests they can order, regardless of the cost.”