TY - JOUR T1 - Treating low back pain in athletes: a systematic review with meta-analysis JF - British Journal of Sports Medicine JO - Br J Sports Med SP - 656 LP - 662 DO - 10.1136/bjsports-2020-102723 VL - 55 IS - 12 AU - Jane S Thornton AU - J P Caneiro AU - Jan Hartvigsen AU - Clare L Ardern AU - Anders Vinther AU - Kellie Wilkie AU - Larissa Trease AU - Kathryn E Ackerman AU - Kathryn Dane AU - Sarah-Jane McDonnell AU - David Mockler AU - Conor Gissane AU - Fiona Wilson Y1 - 2021/06/01 UR - http://bjsm.bmj.com/content/55/12/656.abstract N2 - Objective To summarise the evidence for non-pharmacological management of low back pain (LBP) in athletes, a common problem in sport that can negatively impact performance and contribute to early retirement.Data sources Five databases (EMBASE, Medline, CINAHL, Web of Science, Scopus) were searched from inception to September 2020. The main outcomes of interest were pain, disability and return to sport (RTS).Results Among 1629 references, 14 randomised controlled trials (RCTs) involving 541 athletes were included. The trials had biases across multiple domains including performance, attrition and reporting. Treatments included exercise, biomechanical modifications and manual therapy. There were no trials evaluating the efficacy of surgery or injections. Exercise was the most frequently investigated treatment; no RTS data were reported for any exercise intervention. There was a reduction in pain and disability reported after all treatments.Conclusions While several treatments for LBP in athletes improved pain and function, it was unclear what the most effective treatments were, and for whom. Exercise approaches generally reduced pain and improved function in athletes with LBP, but the effect on RTS is unknown. No conclusions regarding the value of manual therapy (massage, spinal manipulation) or biomechanical modifications alone could be drawn because of insufficient evidence. High-quality RCTs are urgently needed to determine the effect of commonly used interventions in treating LBP in athletes. ER -