Background Back pain (BP) is a frequent health problem in the general population resulting in enormous costs for the health care system. It is also one of the most frequently occurring complaints in sports.

Objective To determine lifetime prevalence (LTP), 12-months prevalence (12-mP) and point prevalence (PP) of BP regarding the pain intensity and the localization at the spine in German elite athletes compared to an active control group (CG) and to identify potential risk factors for BP.

Design The study was designed as a cross-sectional retrospective survey.

Setting A validated online BP questionnaire (Kourinka, 1987; von Korff, 1992) was sent by the German Olympic Sports Confederation to approximately 4,000 athletes, and to a CG of 253 physically active but non-elite sports students.

Participants N=1114 athletes (m=46.5%, f=53.1%, 20.9±4.8 years, 176.5±11.5 cm, 71.0±10.3 kg) and 166 physically active students (m=74.7%, f=24.1%, 21.2±2.0 years, 180.0±8.0 cm, 74.0±14.5 kg) took part.

Main Outcome Measurements LTP, 12-mP, PP and risk factors of BP were determined.

Results LTP of BP was 88.5%, 12-mP was 81.1% and PP was 49.0%, compared with 80.7%, 70.0% and 42.8%, respectively in the CG. The LTP and 12-mP in athletes were significantly higher than in the CG. The most often occurred localization was the lower back. Regarding the sports disciplines individually LTP of BP ranged between 58–100%. High prevalence rates of 95–100% were found in fencing, rowing, water-polo, diving, shooting and dancing.

Conclusions Findings indicate that BP is a present problem in athletes. Especially sports with high mechanical loads on the spine seem to be affected. Athletes, physicians and coaches should be aware of this, and seek to identify specific prevention programs, especially in high-risk sports. These programs should be part of elite athletes' daily training.

Acknowledgement: The study was supported by the Federal Institute for Sport Science, Germany (ZMVI1–080102A/11–18).