Ask the Doctor – Golf and Back Pain

Although golf is considered a less traumatic sport, injuries often happen. Whether you are a duffer, a serious golfer, or a PGA Tour player, you may be susceptible to a golf-related back injury. Statistics have shown that more than 35% of novice golfers and more than 63% of serious golfers have experienced a spinal injury or back pain. Professional golfers experience nearly double the incidence of back pain compared to recreational golfers. Back injuries can happen in both younger and older golfers, however age, greater body mass, weight and history of previous back pain are the most at-risk factors. 

Have you experienced back pain during or after a round of golf? Don’t let back pain hinder your “A” game. We’ve asked Dr. John East of Addison Pain + Regenerative Medicine to tell us about the types of non-surgical treatment options available and what recovery are might look like for a golfer experiencing back pain. 

How can playing golf cause back pain?  

Playing golf requires serious stamina and repetitive movements both of which can cause overuse or lack of control through the swing. The rotational forces of the golf swing create an inherent risk to the lumber spine due to the compression of the discs, especially if the golfer hyperextends or over rotates. This type of movement can cause injury to the spinal discs or lumbar facet joints. The SI (sacroiliac) joint can be impacted too from the torsion effect of rotating the spine as the ligaments are stretching on one side as the joint is compressing on the other side. 

What are the symptoms of golf-related back injuries? 

If you experience back pain during or after a round of golf, then your pain is most likely caused from your body movement during the game. The most common complaint from golfers is pain in the low back or lumber region. However, golfers may also experience pain in the middle or upper back. Golf-related back injuries may result in pain referred into the buttocks, hips or legs. If you are experiencing any of these symptoms, you should consult your doctor.

How can I prevent back pain in my golf game?

Spend time developing the right technique instead of using power or force in your swing. Using more skill and technique will reduce stress to the joints. Also, be sure to avoid any golf instruction that encourages a restriction of the hip turn in the backswing in effort to “coil” for more power. If your power in your swing is overcompensating for strength in other areas, you might need some strength building in your core, meaning your abs, hips, glutes, lats, and obliques. The stronger your core, the more ability you’ll have to compose a smooth and painless golf swing repetitively. If you are experiencing pain, rest and appropriate medical treatment can get you back into the swing of things.

What non-surgical treatments are available for back pain? 

Depending on the diagnosis, there are a few non-surgical treatments available to help ease back pain in your golf game. If the pain is strictly coming from your muscle, then a trigger point injection into the muscle is a simple treatment. 

However, if the working diagnosis involves the facet joint, then a facet joint injection with a steroid like cortisone can provide temporary relief for about 3-6 months. Cortisone injections may help to relieve pain and inflammation but tend to be a band-aid fix. 

As a long-term solution, Dr. East recommends physical therapy combined with regenerative medicine treatments such as platelet-rich plasma (PRP), ozone, PRP with ozone, bone marrow or exosomes to reduce inflammation and help to oxidize the injured tissue to stimulate healing and activate stem cells. 

Another long-term solution for facet joint arthritis can be a rhizotomy. A rhizotomy is a procedure that uses thermal energy (heat) to create a pin-point lesion in the nerve that relays pain information from the joint. This in turn effectively prevents the joint from being able to send the chronic pain signal to the brain. The nerve typically regrows between six months to a year. At that point, if the pain returns, another rhizotomy can be performed and would be covered by most insurance plans. 

How long do I have to wait after treatment to get back on the green? 

Ultimately, it depends on the severity of the pain and symptoms, as well as how much damage has been done. Some patients can get back on the course right away, and for others it may take more time. Most regenerative medicine patients see results within a few weeks of the procedure, but it may take up to 3 months. Some patients need more than one treatment. If the discomfort is minimal, it’s important to keep the joints active and get back to your game (or life) right away if your body allows. 

John East, D.O. is the owner of Addison Pain + Regenerative Medicine serving the DFW Metroplex. Dr. East has been practicing regenerative medicine since 2014 and is a leader in this field. He is board-certified in both Physical Medicine & Rehabilitation (PM&R) and Pain Medicine. Dr. East has completed advanced training and certification at the Institute of Regenerative Medicine and is a member of the American Academy of Stem Cell Physicians (AASCP). Dr. East continues to study new treatment options and performs clinical trials surrounding the field of regenerative medicine. His latest endeavor is the completion of ozone certification and advanced Prolozone with Dr. Frank Shallenberger.