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International Olympic Committee consensus statement on pain management in elite athletes
  1. Brian Hainline1,
  2. Wayne Derman2,
  3. Alan Vernec3,
  4. Richard Budgett4,
  5. Masataka Deie5,
  6. Jiří Dvořák6,
  7. Chris Harle7,
  8. Stanley A Herring8,
  9. Mike McNamee9,
  10. Willem Meeuwisse10,
  11. G Lorimer Moseley11,
  12. Bade Omololu12,
  13. John Orchard13,
  14. Andrew Pipe14,
  15. Babette M Pluim15,
  16. Johan Ræder16,
  17. Christian Siebert17,
  18. Mike Stewart18,
  19. Mark Stuart19,
  20. Judith A Turner20,
  21. Mark Ware21,
  22. David Zideman22,
  23. Lars Engebretsen4
  1. 1 National Collegiate Athletic Association (NCAA), Indianapolis, Indiana, USA
  2. 2 Stellenbosch University, Stellenbosch, South Africa
  3. 3 World Anti-Doping Agency, Montreal, Canada
  4. 4 International Olympic Committee, Lausanne, Switzerland
  5. 5 Aichi Medical University, Nagakute, Japan
  6. 6 Department of Neurology, Schulthess Clinic Zurich, Zürich, Switzerland
  7. 7 Department of Health Policy and Management, Indiana University, Indianapolis, Indiana, USA
  8. 8 University of Washington, Seattle, Washington, USA
  9. 9 Swansea University, Swansea, UK
  10. 10 University of Calgary, Calgary, Canada
  11. 11 University of South Australia, Adelaide, South Australia
  12. 12 University of Ibadan College of Medicine, Ibadan, Nigeria
  13. 13 Cricket Australia, Melbourne, Australia
  14. 14 University of Ottawa Heart Institute, Ottawa, Canada
  15. 15 Chief Medical Adviser, Koninklijke Nederlandse Lawn Tennis Bond (KNLTB), Amersfoort, The Netherlands
  16. 16 Oslo University, Oslo, Norway
  17. 17 Hanover Medical School, Hanover, Germany
  18. 18 East Kent Hospitals University NHS Foundation Trust, Canterbury, Great Britain
  19. 19 Mark Stuart, Bpharm FFRPS FRPharmS, BJM, London, UK
  20. 20 University of Washington, Seattle, Washington, USA
  21. 21 MBBS MRCP, McGill University Health Centre, Montreal, Canada
  22. 22 International Olympic Committee Medical and Scientific Games Group, Lausanne, Switzerland
  1. Correspondence to Dr Brian Hainline, National Collegiate Athletic Association (NCAA), Indianapolis, Indiana 46206, US; bhainline{at}


Pain is a common problem among elite athletes and is frequently associated with sport injury. Both pain and injury interfere with the performance of elite athletes. There are currently no evidence-based or consensus-based guidelines for the management of pain in elite athletes. Typically, pain management consists of the provision of analgesics, rest and physical therapy. More appropriately, a treatment strategy should address all contributors to pain including underlying pathophysiology, biomechanical abnormalities and psychosocial issues, and should employ therapies providing optimal benefit and minimal harm. To advance the development of a more standardised, evidence-informed approach to pain management in elite athletes, an IOC Consensus Group critically evaluated the current state of the science and practice of pain management in sport and prepared recommendations for a more unified approach to this important topic.

  • Athlete
  • Consensus Statement
  • Drug Use
  • Ethics
  • Injury

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  • Disclaimer This consensus paper provides an overview of pain management issues in elite athletes that are important to physicians and other clinicians who treat elite athletes. It is not intended as a clinical practice guideline or legal standard of care and should not be interpreted as such. This consensus paper serves as a guide and, as such, is of a general nature, consistent with the reasonable practice of the healthcare professional. Individual treatment will depend on the facts and circumstances specific to each individual case.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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