Article Text

Download PDFPDF
Prevalence and risk factors for back pain in sports: a systematic review with meta-analysis
  1. Fiona Wilson1,
  2. Clare L Ardern2,3,
  3. Jan Hartvigsen4,5,
  4. Kathryn Dane1,
  5. Katharina Trompeter6,7,
  6. Larissa Trease8,
  7. Anders Vinther9,
  8. Conor Gissane1,
  9. Sarah-Jane McDonnell10,
  10. JP Caneiro11,
  11. Craig Newlands12,
  12. Kellie Wilkie13,
  13. David Mockler14,
  14. Jane S Thornton15,16
  1. 1 Discipline of Physiotherapy, School of Medicine, Trinity College, Dublin, Ireland
  2. 2 Division of Physiotherapy, Karolinska Institute, Stockholm, Sweden
  3. 3 Sport & Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
  4. 4 Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
  5. 5 Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
  6. 6 Department of Sports Medicine and Sports Nutrition, Ruhr University Bochum, Bochum, Germany
  7. 7 Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
  8. 8 Healthcare in Remote and Extreme Environments program, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
  9. 9 Department of Physiotherapy and Occupational Therapy and QD-Research Unit, Copenhagen University Hospital, Herlev and Gentofte, Copenhagen, Denmark
  10. 10 Sport Ireland Institute, Dublin, Ireland
  11. 11 School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia
  12. 12 Body Performance, Cambridge, New Zealand
  13. 13 Bodysystem Physiotherapy, Hobart, Tasmania, Australia
  14. 14 John Stearne Library, Trinity College Dublin, Dublin, Ireland
  15. 15 Fowler Kennedy Sports Medicine Clinic, Western University, London, Ontario, Canada
  16. 16 Western Centre for Public Health and Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
  1. Correspondence to Dr Fiona Wilson, Discipline Of Physiotherapy, Trinity College Dublin, Dublin 2, Ireland; wilsonf{at}


Objectives We aimed to determine the prevalence of low back pain (LBP) in sport, and what risk factors were associated with LBP in athletes.

Design Systematic review with meta-analysis.

Data sources Literature searches from database inception to June 2019 in Medline, Embase, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Web of Science and Scopus, supplemented by grey literature searching.

Eligibility criteria Studies evaluating prevalence of LBP in adult athletes across all sports.

Results Eighty-six studies were included (30 732, range 20–5958, participants), of which 45 were of ‘high’ quality. Definitions of LBP varied widely, and in 17 studies, no definition was provided. High-quality studies were pooled and the mean point prevalence across six studies was 42%; range 18%–80% (95% CI 27% to 58%, I2=97%). Lifetime prevalence across 13 studies was 63%; range 36%–88% (95% CI 51% to 74%, I2=99%). Twelve-month LBP prevalence from 22 studies was 51%; range 12%–94% (95% CI 41% to 61%, I2=98%). Comparison across sports was limited by participant numbers, study quality and methodologies, and varying LBP definitions. Risk factors for LBP included history of a previous episode with a pooled OR of 3.5; range 1.6–4.0 (95% CI 1.9 to 6.4). Statistically significant associations were reported for high training volume, periods of load increase and years of exposure to the sport.

Conclusion LBP in sport is common but estimates vary. Current evidence is insufficient to identify which sports are at highest risk. A previous episode of LBP, high training volume, periods of load increase and years of exposure are common risk factors.

  • athlete
  • epidemiology
  • lower back
  • lumbar spine
  • sport

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Twitter @fionawilsonf, @clare_ardern, @DrLarissaTrease, @janesthornton

  • Contributors FW, KW, JST, LT and AV designed concept, project managed and assisted with manuscript writing, editing and data extraction. S-JM and CN assisted with data extraction and paper reviews. JPC: data interpretation and manuscript writing. CG: data analysis. DM: search strategy. KD: editing, creating tables and quality review. KT: quality review. CLA and JH: project management and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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