Expert: Scott F. Gillman, DC, DACBSP - 3/9/2010

Question
My 15 year old daughter has mid back pain and feels spasms now and then. She is 5'1"and weighs close to 100 lbs. She was a competitive dancer and danced over 20 hours a week but in the past 2 years has limited that to 3 -4 hours a week. The back pain seems to be worse now. She has started swimming and hockey. She also has to use the computer a lot for school and I find she is slouched in front of it. A physiotherapist here in Toronto evaluated her and said she had 2 rotated vertebrae. I read in one of your answers on this site that you do not agree with these diagnosis (misalignment). You suggested joint assessment and checking into myofascial irritation. What type of professional could do that kind of assessment? Also, would core strengthening help her - this has been recommended to her.

Answer
Marielle,

You need to have your daughter checked for what's called "spondylolysis" or "acute pars defect."   This is a stress fracture to the bone.  She may need to undergo MRI to see if there is a fracture or the stage prior to fracture, called a stress response.  A stress response, or the pending stage just prior to fracture will show up as swelling in the bone marrow on one part of the vertebra called the "pars interarticularis."   A consult with a good chiropractor will be helpful. If you are in Toronto, see:  Dr. Thien Dang Tan, Clinic Director; Fitness Institute - North York 2225 Sheppard Ave E. #101 Toronto, Ontario (416) 492-7611  www.clinicforsportmed.ca

If you daughter has a totally normal MRI, then she should obtain some treatment.  If she has early stage stress fracture, she should go into a "Boston Brace."   No core strengthening until a sports chiropractor examines her.   She must be able to perform a standing "Kemps test" as well as a "Stork Test."   If these give her a jolt of pain, then MRI is needed.   You should be able to google these terms.  Otherwise, see the doctor I referred to (above).  He will describe them.

'Hope this helps.

Dr. G