Welcome back to Spine IQ’s Back Blog! It is Superbowl week with the Los Angeles Rams and Cincinnati Bengals facing off on Sunday afternoon. Along with the Superbowl, the Winter Olympics are currently being played. We wanted to continue with this sports theme and discuss low back pain in athletes. While sports are incredibly popular globally and they captivate so many people, athletes tend to be understudied compared to the general population. This blog will discuss the prevalence and risk factors of low back pain in the athletic population and next week, we will discuss strategies for treating athletes with low back pain in your clinic.
Prevalence
Olympians are the most well-studied athletic population. Studies report that 9 out of 10 Olympians experience an episode of disabling low back pain in their lifetime and at any one point, 2 out of 3 Olympians are experiencing an episode of disabling low back pain.1 However, most of us do not treat Olympians so it is important to look at studies evaluating athletes more broadly. High quality studies suggest that 63% of athletes will experience a disabling episode of low back pain in their lifetime.2 Additionally, high quality studies report that 51% of athletes will experience an episode of disabling low back pain within 12-months.2 At any one point, high quality studies report that 42% of athletes are experiencing an episode of disabling low back pain.2
While the majority of low back pain episodes are short and self-limiting, there are some athletes that experience disabling low back pain for longer period of time. The median amount of time missed was 23 days for a disc injury and 169 days for lumbar stress fracture.3 Additionally, 1 in 4 triathletes report chronic low back pain (>3 months).4
Risk Factors
As commonly suspected, periods of time with higher training volume, intensity, and transitioning from pre-season to in-season increased the likelihood of experiencing an episode of low back pain.5 Longer time spent competing in the sport increased the risk of low back pain, however, age was not found to be a consistent risk factor for low back pain.2 Just like in the general population, a previous episode of low back pain increased the likelihood of a future episode of low back pain.2 There were no consistent associations between an episode of low back pain and gender, imaging findings (e.g., MRI, X-rays, and ultrasounds), and movement screenings.2
Conclusion
There are some significant commonalities between low back pain in athletes and the general population, which may provide some insight into the treatment of the patients we call “weekend warriors”. Research has shown however, that the lifetime, 12-month, and one time prevalence seem to be just as common in athletes as it is in the general population. However, there are some special things to consider with athletes like timing of the season and intensity of workouts that may increase the risk of low back pain. Next week, we will discuss some tips and advice on treating athletes with low back pain, stay tuned!
References:
- Trompeter K, Fett D, Platen P. Prevalence of Back Pain in Sports: A Systematic Review of the Literature. Sports Med Auckl NZ. 2017;47(6):1183-1207. doi:10.1007/s40279-016-0645-3
- Wilson F, Ardern CL, Hartvigsen J, et al. Prevalence and risk factors for back pain in sports: a systematic review with meta-analysis. Br J Sports Med. Published online October 19, 2020:bjsports-2020-102537. doi:10.1136/bjsports-2020-102537
- Gray BL, Buchowski JM, Bumpass DB, Lehman RA, Mall NA, Matava MJ. Disc herniations in the national football league. Spine. 2013;38(38):1934-1938. doi:10.1097/BRS.0b013e3182a67678
- Villavicencio AT, Burneikiene S, Hernández TD, Thramann J. Back and neck pain in triathletes. Neurosurg Focus. 2006;21(4):E7. doi:10.3171/foc.2006.21.4.8
- Ng L, Sherry D, Loh WB, et al. The prevalence and severity of injuries in field hockey drag flickers: a retrospective cross-sectional study. J Sports Sci. 2016;34(18):1746-1751. doi:10.1080/02640414.2015.1136072