Back pain and MRI changes in the thoraco-lumbar spine of top athletes in four different sports: a 15-year follow-up study

Abstract

A total 71 male athletes (weight lifters, wrestlers, orienteers, and ice-hockey players) and 21 non-athletes were randomly selected, for a baseline MRI study. After 15 years all the participants at baseline were invited to take part in a follow-up examination, including a questionnaire on back pain and a follow-up MRI examination. Thirty-two athletes and all non-athletes had disc height reduction at one or several disc levels. Disc degeneration was found in more than 90% of the athletes and deterioration had occurred in 88% of the athletes, with the highest frequency in weight lifters and ice-hockey players. 78% of the athletes and 38% of the non-athletes reported previous or present history of back pain at baseline and 71 and 75%, respectively at follow-up. There was no statistically significant correlation between back pain and MRI changes. In conclusion, athletes in sports with severe or moderate demands on the back run a high risk of developing disc degeneration and other abnormalities of the spine on MRI and they report high frequency of back pain. The study confirmed our hypothesis, i.e. that most of the spinal abnormalities in athletes seem to occur during the growth spurt, since the majority of the abnormalities demonstrated at follow-up MRI after the sports career were present already at baseline. The abnormalities found at young age deteriorated to a varying degree during the 15-year follow-up, probably due to a combination of continued high load sporting activities and normal ageing. Preventive measures should be considered to avoid the development of these injuries in young athletes.

Thoracolumbar Injuries in Pediatric Athletes: Diagnosis, Treatment, Rehabilitation, and Prevention

“…The prevalence of back pain is much higher among active athletes participating in sports with heavy loads on the spine than among other athletes and nonathletes, and it has been reported in between 10 % and 91 % of athletes (Jackson 1979;Sward et al 1990b;Harvey and Tanner 1991;Eriksson et al 1996;Kujala et al 1996a;Sassmannshausen and Smith 2002;Bahr et al 2004;Baranto et al 2006Baranto et al , 2009b. Back pain among athletes may result from acute macrotrauma, repetitive microtrauma (stress), or a combination of these two mechanisms (Kujala et al 1996b).…”

“…However, as back pain is also a common symptom in the general population, it has been difficult firmly to establish, in the literature, the relationship between plain radiography or MRI findings and back pain. However, in recent studies, these anatomic abnormalities have been reported to be correlated with the symptoms (Sward et al 1991;Kujala et al 1996a; Baranto et al 2006Baranto et al , 2009b.…”

“…Endplate fractures are considered to be caused by an acute axial load or are far more frequently caused by repetitive axial stresses (Barile et al 2007). Baranto et al reported a higher incidence of these injuries in orienteers compared with other athletes (Baranto et al 2009b).…”

“…Acute macrotrauma, repetitive microtrauma or overuse injuries, or a combination of these two mechanisms can result in spinal injuries in pediatric athletes, resulting in low back pain (Jackson 1979;Sward et al 1991;Baranto et al 2009bBaranto et al , 2010. Repetitive bending of the back (e.g., in gymnastics and diving) and twisting (e.g., in tennis and baseball) increases the risk of spinal injuries in young athletes.…”

Posture of adolescent male handball players compared to non-athletes

“…Intensive exercises causing spinal strain from the earliest years may increase the risk of developing musculoskeletal disorders and affect the process of growth [5,6]. Moreover, participation in sports activities is related to the risk of injuries.…”