Pars fracture and disc desiccation diagnosed. Using brace for back pain. Will a bone stimulator help?
Patient: My 15 yr old son has been diagnosed by an orthopaedic dr (actually 2 of them) with a pars fracture (bilateral) and disc desiccation of L4-L5.  He shut down for football season and rested in a brace for 6 weeks in October, then began PT/core strengthening for 6-8 more weeks.  Back pain was better and he eased into wrestling season and did well for about a month, when the back pain came back.  He has had xrays, 3 mris and most recently a CT scan.  He shut down again at the beginning of baseball season and has been resting for 6 weeks.  Still has back pain.  Plan is currently to rest until June 1st and then try PT, swimming, core strengthening again and try to go back to football in August.  I'm wondering if it is more likely that the pars fracture or the disc degeneration is causing the pain?  What treatment do you suggest?  Do you think he will have to have surgery of some sort to return to competitive sports?  Sports are his world!!  Would a bone stimulator help?  Does he need a bone scan to determine if the fracture is hot or cold?  Please help! :( Doctor: Hi, Thank you for posting your query. It is unfortunate that his pain has not completely settled even after about six months of rest and physiotherapy. Pars fracture pain is unlikely to persist for this long. Also, L4-5 disc degeneration pain should get better with physiotherapy. So, I would suggest further evaluation with bone scan and may be a local epidural injection for pain relief. Please get back if you require any additional information.  Best wishes,  Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:  http://bit.ly/Dr-Sudhir-kumar  My email: drsudhirkumar@yahoo.com