The case study presented in this article is of a 13 y/o female dancer c/o insidious onset and progressive pain at the thoracolumbar junction and upper lumbar region for approximately 4 months. Her pain progressively increased each week following hip-hop class when she had to practice choreography that included backbends and kip-ups (laying supine on the floor and quickly kicking up to a standing position). Her deep and achy pain that increased in intensity over several hours following training was also increased with trunk extension, but she denied radiating pain, difficulty breathing, or bowel/bladder problems. She received 10 weeks of treatment to alleviate symptoms, the patient had a 2-week break in her dance training. During this break, her symptoms did not improve. At this time, diagnostic imaging was performed to identify a more accurate diagnosis. The plain x-rays and MRI indicated inflammatory apophysitis of the L1-L3 spinous processes. The authors wrote this case study to identify delineations between spinous process apophysitis and the more common and debilitating diagnosis of spondylolysis. While specific symptom patterns and causes of pain will differ between the two conditions, the authors also recommend early x-rays and MRI with STIR sequencing to identify the exact location of the vertebral pathology causing low back pain.
Quinlan E, Reinke T, Bogar WC. Spinous process apophysitis: A cause of low back pain following repetitive hyperextension in an adolescent female dancer. J Dance Med Sci. 2013;17(4):170-4
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