Skip to main content

Advertisement

SpringerLink
Log in

Management of Back Pain in Athletes

  • Injury Clinic
  • Published:
Sports Medicine Aims and scope Submit manuscript

Summary

Back pain affects millions of people. It affects 80% of the population and up to 52% at any given time. Back pain is not limited to sedentary individuals; it has significant effects on athletes as well. Depending upon the sport, incidence rates of back pain occur in athletes from 1.1% to as high as 30%. Athletes differ from the non-athletic population in that their incentives to return to activity are considerably different than non-athletes. The reasons may vary from the will to win through to significant financial considerations. Although reasons for recovery are different, the physiology and mechanics of repair of injured soft tissue in the athlete is the same as for the non-athlete. Proper management of the athlete requires ruling out emergent causes of back pain such as tumour, infection, acute fracture, progressive neurological deficit, visceral sources (e.g. pancreatitis, abdominal aortic aneurysm), and rheumatoid variants. Once a good history and physical is performed, a simple classification system can be utilised to manage the athlete presenting with back pain. This system can be expressed as: (a) regional back pain; (b) radicular leg pain; (c) radicular leg pain with progressive neurological deficit; and (d) cauda equina syndrome. Each of these categories needs to be managed in a specific manner and can provide the healthcare professional with simple, straightforward guidelines for handling the athlete with lower back pain. The key is to return the athlete to the field of play in a safe and timely manner.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Frymoyer JW. Back pain and sciatica. N Engl J Med 1988; 318(5): 291–300

    Article  PubMed  CAS  Google Scholar 

  2. Deyo RA, Tsui-Wu YJ. Descriptive epidemiology of low-back pain and its related medical care in the United States. Spine 1987; 12(3): 264–8

    Article  PubMed  CAS  Google Scholar 

  3. Andersson GBJ, Pope MH, Frymoyer JW. Epidemiology. In: Pope MH, Frymoyer JW, Andersson GBJ, editors. Occupational low back pain. New York: Praeger, 1984: 101–14

    Google Scholar 

  4. Cypress BK. Characteristics of physician visits for back symptoms: a national perspective. Am J Public Health 1983; 73(4): 389–95

    Article  PubMed  CAS  Google Scholar 

  5. Maxwell C, Spiegal A. The rehabilitation of athletes following spinal injuries. The spine in sports. Philadelphia: Hanley and Belfus, 1990: 281–92

    Google Scholar 

  6. Tall RL, Devault W. Spinal injury in sport: epidemiological considerations in clinical sports medicine. Clin Sports Med 1993; 12(3): 441–8

    PubMed  CAS  Google Scholar 

  7. Roher MH, Santos-Eigmann B, Paccaud F, et al. Epidemiologic study of low back pain in 1398 Swiss conscripts between 1985 and 1992. Eur Spine J 1994; 3(1): 2–7

    Article  Google Scholar 

  8. Jackson DW, Sutker A. Low back problems in runners. AAOS Symposium on the foot and leg in running sports. 1980 Sep; Coronado (CA): Mosby, 1982: 123–34

    Google Scholar 

  9. Spencer CW, Jackson DW. Back injuries in athletes. In: Spencer CW, Jackson DW, editors. Sports neurology. Rockfield: Aspen Publishers, 1982: 159–77

    Google Scholar 

  10. McCarroll JR, Gioe TJ. Professional golfers and the price they pay. Phys Sports Med 1982; 10: 64

    Google Scholar 

  11. Jackson D, Forman W, Benson B. Pattems of injuries in college athletes: a retrospective study of injuries sustained in intercollegiate athletics in a two year period. Mount Sinai J Med 1980; 47(2): 423–6

    CAS  Google Scholar 

  12. Garrick JG, Requa RK. Epidemiology of women’s gymnastics injuries. Am J Sports Med 1980; 8(4): 261–4

    Article  PubMed  CAS  Google Scholar 

  13. Glick J, Katch V. Musculoskeletal injuries in jogging. Arch Phys Med Rehabil 1970; 51(3): 123–6

    PubMed  CAS  Google Scholar 

  14. Nachemson A. Newest knowledge of low back pain. A critical look. Clin Orthop 1992; 279: 8–20

    PubMed  Google Scholar 

  15. Agency for Health Care Policy and Research. Clinical guidelines for low back pain. Washington: Agency for Health Care Policy and Research, 1994

    Google Scholar 

  16. Micheli LJ, Wood R. Back pain in young athletes. Significant differences from adults in causes and patterns. Arch Pediatr Adolesc Med 1995; 149(1): 15–8

    Article  PubMed  CAS  Google Scholar 

  17. Blanda J, Bethem D, Moats W, et al. Defects of pars inter-articularis in athletes: a protocol for nonoperative treatment. J Spinal Disord 1993; 6(5): 406–11

    Article  PubMed  CAS  Google Scholar 

  18. Mundt DJ, Kelsey JL, Golden AL, et al. An epidemiologic study of sports and weight lifting as possible risk factors for herniated lumbar and cervical discs. The Northeast Collaborative on Low Back Pain. Am J Sports Med 1993; 21(6): 854–60

    Article  PubMed  CAS  Google Scholar 

  19. Salminen JJ, Oksanen A, Make P, et al. Leisure time physical activity in the young. Correlation with low-back pain, spinal mobility and trunk muscle strength in 15-year-old school children. Int J Sports Med 1993; 14(7): 406–10

    Article  PubMed  CAS  Google Scholar 

  20. Kujala UM, Salminen JJ, Taimela S. Subject characteristics and low back pain in young athletes and nonathletes. Med Sci Sports Exerc 1992; 24(6): 627–32

    PubMed  CAS  Google Scholar 

  21. Carpenter D, Brigham T, Welsch M. Low back strength comparison of elite female collegiate athletes [abstract]. Med Sci Sport Exerc 1994; 26(5): S113

    Google Scholar 

  22. Szuba SF, Graves JE, Reider LR. Lumbar extension strength and rowing performance in collegiate rowers [abstract]. Med Sci Sports Exerc 1994; 26(5): S153

    Google Scholar 

  23. Boden SD. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am 1990; 72(3): 403–8

    PubMed  CAS  Google Scholar 

  24. Spetzer WO. Scientific approach to the assessment and management of activity related spinal disorders — a monograph for clinicians. Report of the Quebec Task Force. Spine 1987; 12(7): 1–59

    Google Scholar 

  25. Saal JA, Saal JS. Non-operative treatment of herniated lumbar intervertebral disc with radiculopathy: an outcome study. Spine 1989; 14(4): 431–7

    Article  PubMed  CAS  Google Scholar 

  26. Delauche-Cavallier MC, Budet C, Laredo JD. Lumbar disc herniation. Computed tomography scan changes after conservative treatment of nerve root compression. Spine 1992; 17(8): 927–33

    Article  PubMed  CAS  Google Scholar 

  27. MacIntosh JE, Valencia F, Bogduk N. The morphology of the human lumbar multifidus. Clin Biomechanics 1986; 1(4): 196–204

    Article  Google Scholar 

  28. Jowett RL, Fidler MW, Troup JDG. Histochemical changes in the multifidus in mechanical derangements of the spine. Orthop Clin North Am 1975; 6(1): 145–61

    PubMed  CAS  Google Scholar 

  29. Fidler MW, Jowett RL, Troup DG. Myosin ATPase activity in multifidus muscle from cases of lumbar spinal derangement. J Bone Joint Surg 1975; 57B(2): 220–7

    Google Scholar 

  30. Lehto M, Hurme M, Alaranta H, et al. Connective tissue characteristics of the multifidus muscle in patients with lumbar disc herniation. An immunohistologic study of collagen types I and III fibronectin. Spine 1989; 14(3): 302–9

    Article  PubMed  CAS  Google Scholar 

  31. Mattila M, Hurme M, Alaranta H, et al. The multifidus muscle in patients with lumbar disc herniation. A histochemical and morphometric analysis of intraoperative biopsies. Spine 1986; 11(7): 732–8

    Article  PubMed  CAS  Google Scholar 

  32. Nelson BW, O’Reilly EJ, Miller MM. The clinical effects of intensive, specific exercise on chronic low back pain: a prospective study with one year follow-up. Orthopedics 1995; 18(10): 971–81

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Columbia Spine Center, 400 Keene Street, Columbia, Missouri, 65201, USA

    Thomas E. Dreisinger

  2. Physician’s Neck and Back Clinic, Roseville, Minnesota, USA

    Brian Nelson

Authors
  1. Thomas E. Dreisinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Brian Nelson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thomas E. Dreisinger.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dreisinger, T.E., Nelson, B. Management of Back Pain in Athletes. Sports Med 21, 313–320 (1996). https://doi.org/10.2165/00007256-199621040-00006

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-199621040-00006

Keywords

Search

Navigation