Low Back Pain in Athletes Is Associated with General and Sport Specific Risk Factors: A Comprehensive Review of Longitudinal Studies

Abstract

We aimed to examine systematically the available evidence on risk factors of low back pain (LBP) in athletes. We performed search without language restriction in PubMed, Ovid, Google Scholar, Scopus, and CINAHL. Longitudinal studies that examined possible risk factors of LBP in athletes were included in this systematic review. Based on methodological quality of studies, a best-evidence synthesis was conducted. Seven longitudinal studies were included, four of which had high methodological quality. Results showed that previous LBP, decreased lumbar flexion, and decreased lumbar extension are positively associated with LBP. There was moderate evidence for hip flexor tightness and high body weight as a risk factor. We found insufficient evidence for association between forward bending, previous injury, and amount of training per week, active years, age, and sex with LBP. In conclusion this study would provide a list of risk factors for LBP in athletes, though it showed a strong evidence for only a few including decrease lumbar flexion or extension, previous LBP, and high body weight. This review indicated a high heterogeneity of study characteristics including assessed risk factors and statistical techniques might limit the quality of evidence.

Low back pain and FokI (rs2228570) polymorphism of vitamin D receptor in athletes

“…On average LBP positive subjects had 3.1 ± 3.0 LBP episodes lifelong. However, none of the subjects declaring the LBP symptom had a specific medical diagnosis [ 7 ], accordingly, they were non-specific LBP cases [ 9 , 10 ].…”

“…At present, the scientific interest in the risk factors for LBP is increasing both for athletic performance and health implications [ 9 , 10 ]. Further research is required in this field because discrepancies exist among studies especially regarding LBP prevalence, causes, and therapeutic strategies [ 9 , 12 , 35 ]. In addition, sex-specific studies are warranted to take into account sex differences in factors potentially modulating LBP [ 10 , 14 ].…”

“…In studies were lumbar spine pain is evaluated as a symptom by questionnaire, it had a prevalence of around 30–40% [ 1 , 2 , 8 ]. Prevalence of LBP seems to vary according to type of sport discipline [ 9 ], rates over 70% were reported for bowling/skittles, canoe, cycling, gymnastics, rowing, shooting, snowboarding, and volleyball [ 8 ]. A recent Iranian study [ 10 ] among college female athletes found a life-time prevalence of LBP of nearly 70% in basketball, karate, and track-and-field athletes.…”

“…In the general population many environmental/behavioral risk factors, including age, sex, weight, occupational load, smoking and exposure to vehicle vibration were demonstrated to contribute to spinal degeneration and severe pain [ 7 , 14 , 15 ]. In athletes, exposure to high exercise load [ 16 ], decreased lumbar flexion and extension, shoulder flexibility, and forward bending have been involved in LBP and disc degeneration processes [ 1 , 9 , 17 ]. Recently, some epidemiologic and genetic studies [ 6 , 7 , 14 , 15 , 18 – 20 ] performed in the general non-athletic population supported the notion that LBP and disc degeneration disorders may be affected by genetic polymorphisms of the vitamin D receptor gene ( VDR ) including FokI, BsmI, TaqI and ApaI single nucleotide polymorphisms (SNPs).…”

Physical risk factors for low back pain among young sedentary individuals - A prospective study

“…[15] Another study done by Moradi et al, found that decreased lumbar flexion and decreased lumbar extension are positively associated with LBP. [16] This study found that participants with below 25 abdominal repetitions are 1.35 times more likely to have LBP as compared to 25 repetitions and above. Koley et al, showed the correlation of nonspecific LBP (NSLBP) and aged-matched controls who found a positively significant correlations (P < 0.05) of abdominal muscle endurance with NSLBP.…”