Thoracolumbar Fascia as an Overlooked Diagnosis of Chronic Back Pain: A Case Report of Successful Regenerative Treatments in an Athlete.

BACKGROUND: Chronic nonspecific low back pain is common in elite athletes, often persisting and significantly affecting training and performance despite conventional therapy. CASE REPORT: This case report details the management of a 14-year-old triple jumper with a 16-onth history of chronic nonspecific low back pain. Magnetic resonance imaging was unremarkable, whereas dynamic ultrasound revealed abnormalities of the thoracolumbar fascia. The patient underwent a tiered regenerative injection strategy guided by biotensegrity principles. Initial ultrasound-guided dextrose hydrodissection was performed for adhesiolysis and analgesia, followed by leukocyte-poor platelet-rich plasma and platelet-poor plasma injections intended to promote tissue remodeling. The athlete reported an overall 85%-90% reduction in pain and returned to full training 4 weeks after the platelet-rich plasma/platelet-poor plasma treatment. CONCLUSIONS: This case illustrates that thoracolumbar fascia dysfunction may warrant consideration as a contributor to chronic nonspecific low back pain in young athletes. In our patient, a tiered regenerative approach resulted in substantial pain reduction and return to full training; however, controlled studies are needed to further establish efficacy of this approach or the causal treatment effect.