This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the exams for this article:
 Sports Test 4: Shoulder/Spine/Trauma
Spine Test 3: Perioperative Considerations/Diagnostic Modalities/Surgical R...
CME 1: January, February, March 2004
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bono, C. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bono, C. M.
Related Collections
Right arrow Spine
Right arrow Sports
Right arrow Current Concepts Review
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?
The Journal of Bone and Joint Surgery (American) 86:382-396 (2004)
© 2004 The Journal of Bone and Joint Surgery, Inc.

Current Concepts Review

Low-Back Pain in Athletes

Christopher M. Bono, MD1

1 Department of Orthopaedic Surgery, Boston University Medical Center, 850 Harrison Avenue, Dowling 2 North, Boston, MA 02118. E-mail address: bonocm{at}prodigy.net

Investigation performed at the Department of Orthopaedic Surgery, Boston University Medical Center, Boston, Massachusetts

The author did not receive grants or outside funding in support of his research or preparation of this manuscript. He did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the author is affiliated or associated.

While most occurrences of low-back pain in athletes are self-limited sprains or strains, persistent, chronic, or recurrent symptoms are frequently associated with degenerative lumbar disc disease or spondylolytic stress lesions.

The prevalence of radiographic evidence of disc degeneration is higher in athletes than it is in nonathletes; however, it remains unclear whether this correlates with a higher rate of back pain. Although there is little peer-reviewed clinical information on the subject, it is possible that chronic pain from degenerative disc disease that is recalcitrant after intensive and continuous nonoperative care can be successfully treated with interbody fusion in selected athletes.

In general, the prevalence of spondylolysis is not higher in athletes than it is in nonathletes, although participation in sports involving repetitive hyperextension maneuvers, such as gymnastics, wrestling, and diving, appears to be associated with disproportionately higher rates of spondylolysis.

Nonoperative treatment of spondylolysis results in successful pain relief in approximately 80% of athletes, independent of radiographic evidence of defect healing. In recalcitrant cases, direct surgical repair of the pars interarticularis with internal fixation and bone-grafting can yield high rates of pain relief in competitive athletes and allow a high percentage to return to play.

Sacral stress fractures occur almost exclusively in individuals participating in high-level running sports, such as track or marathon. Treatment includes a brief period of limited weight-bearing followed by progressive mobilization, physical therapy, and return to sports in one to two months, when the pain has resolved.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 Am J Sports MedHome page
M. Fredericson, W. Moore, and S. Biswal
Sacral Stress Fractures: Magnetic Resonance Imaging Not Always Definitive for Early Stage Injuries: A Report of 2 Cases
Am. J. Sports Med., May 1, 2007; 35(5): 835 - 839.
[Full Text] [PDF]

Home page
 Br. J. Sports. Med.Home page
V J Neville, J Molloy, J H M Brooks, D B Speedy, G Atkinson, T Spalding, and J B Allen
Epidemiology of injuries and illnesses in America's Cup yacht racing * Commentary * Commentary.
Br. J. Sports Med., April 1, 2006; 40(4): 304 - 312.
[Abstract] [Full Text] [PDF]

Home page
 ImagingHome page
J Teh, A Imam, and C Watts
Imaging of back pain
Imaging, December 1, 2005; 17(3): 171 - 207.
[Abstract] [Full Text] [PDF]