REPORTED LOW-BACK PAIN AND RADIOLOGICAL CHANGES AMONG FORMER COMPETITIVE ATHLETES

Back pain increases with age during childhood and adolescence. Furthermore, among young athletes back pain has been reported at high incidences suggesting a relationship to physical activity. The severity of the pain was correlated to radiological abnormalities. The objective of a study conducted in Greece was to re-investigate the occurrence of low back pain among athletes 10-12 years later, compared with a group of non-athletes, and to analyze the association of pain and radiological abnormalities of the thoraco-lumbar spine.

The study was a long-term follow-up of 86 athletes and non-athletes who took part in a radiological study of the spine conducted during 1997-1998 years. The initial study consisted of 13 gymnasts, 13 swimmers, 14 tennis players, 14 soccer players, 15 wrestlers and a reference group of 16 non-athletes of comparable age, all male.  All athletes were highly competitive in their sports for at least 4 years preceding the initial study. During 2008-2009 years, all participants were invited to take part in the follow-up study, and 92% (79 participants) agreed. Radiologic examination included AP and lateral views of thoracic and lumbar spine. All participants filled in a questionnaire on back pain and the consequences of it.

They found that 39 athletes (55.7%) and 9 non-athletes (56%) reported moderate or severe back pain. There was no significant difference in the number of participants with back pain between groups of athletes and non-athletes, except for the higher occurrence of severe back pain in wrestlers (60%) than in the other groups of athletes and non-athletes. No correlation between back pain and the different types of radiological abnormalities was detected. However, there was a higher frequency of pain in the case of disk height reduction.

Former competitive athletes do not report more back pain than non-athletes. If disk height reduction occurs between two long-term radiological follow-ups, there is an increased risk of back pain. Although this is a late sign of disk injury, it seems that the most susceptible anatomical structure of the spine to sports injury is the disk. Understanding the etiology of these injuries could be the key to prevention. 

(international  skeletal society meeting 2010 Athens)

Announced by Marmara, E. & Kosmas, I.