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What can be done to prevent pars defect?

Question: What can be done to prevent pars defect?

My son is a 15 year baseball player. Last summer he developed a condition called pars defect. He was released by his dr.last fall. He has recently been experiencing pain in the same area. Today the dr told us he wants to do a bone scan to see if this condition has returned. Has anyone heard of this condition and some of the treatments for it?

Answer:

first of let me let knw wt d condition iz all about.•The pars defect arises at the junction of the descending facet joint and the pedicle of origin. Causation in early childhood may arise as a fracture occasioned by excessive stress due to abnormal alignment of the load transmitting facets (alignment stress).In otherwords the defect cn also b termed as spondylolysis(a defect in the pars interarticularis of a vertebra. The great majority of cases occur in the lowest of the lumbar vertebrae (L5), but spondylolysis may also occur in the other lumbar vertebrae, as well as in the thoracic vertebrae).
This is a common cause of low back pain (LBP) in adolescent athletes(aged 11-17yrs).
As a therapist i must first advice u do d bone scan as per doctors advice. this is just to clear conception of severity.

PHYSICAL THERAPY TREATMENT:
1.Meanwhile a period of rest for an average of 2-4 weeks can provide beneficial effects by modulating pain, decreasing inflammation, and decreasing the risk for further progression of a pars stress reaction to a frank fracture.Applying ice to the injured area for 20 minutes 3-4 times a day in conjunction with performing gentle ROM exercises and stretching of the quadriceps and hamstring muscles is strongly advised. Activity modification is recommended. The patient is advised to stop the activity or sport that evokes the back pain for an average of 2-4 weeks.In particular, the patient should avoid any activities involving hyperextension. SO KINDLY CONSULT A GOOD PHYSIOTHERAPIST FOR STRETCHING OF QUADRICEPS AND HAMSTRINGS MUSCLES.

2.Once the LBP is controlled during the acute phase of treatment, a therapy program can be initiated. If the patient’s symptoms significantly decrease with rest and activity modification, a regimen of hamstring and hip flexor stretching, abdominal strengthening, lumbar flexion exercises, and cross-training with extension precautions can be instituted. If the patient requires the use of a brace, an initial program of hamstring stretching while wearing the brace can be started.

3.As the symptoms continue to decrease, lumbar flexion exercises, abdominal strengthening, and hip flexor and hamstring stretching can be instituted without the use of the brace. Cross-training in nonextension activities can be performed, such as the stationary bike and hydrotherapy.

4.home regimen is advised.

SURGICAL INTERVENTION:
Indications for surgery include (1) persistent pain unrelieved by rest and immobilization for more than 6 months, (2) progression to spondylolisthesis, (3) spondylolisthesis of greater than grade II in a patient about to undergo the preadolescent growth spurt, and (4) any significant neurologic abnormalities.3,46,70 As discussed above, the prognosis of bone healing is dependent on the stage of the spondylolytic lesion.11 Dubousset reported that if treatment is delayed for 3 months or more after the fracture occurs, nonoperative treatment is unsuccessful.71 Surgical options include direct repair of the spondylolytic defect, fusion in situ, reduction and fusion, and vertebrectomy.

MEDICATION(under the guidance of the physician):
Medications recommended for the treatment of pain in spondylolysis include nonsteroidal anti-inflammatory drugs:
1(NSAIDs)[Ibuprofen (Ibuprin, Motrin);Celecoxib (Celebrex);Naproxen (Naprosyn, Naprelan, Anaprox)],
2.Analgesics[Acetaminophen (Tylenol, Feverall, Tempra)], and
3.Muscle relaxants[Cyclobenzaprine (Flexeril).

NOTE:Before prescribing these medications, review the contraindications, adverse side effects, and mode of action.