Backache in Sportspersons Posted on Thursday, September 11, 2003 - 00:00 Mechanism of Injury: Backache may occur in a number of sports due to overloading. It must be remembered that backache is the complaint in approximately 20% of all orthopaedic patients and that the pain may not be necessarily due to sport. Sports: Certain sports are more likely to cause backache than others. Contact sports, eg rugby and soccer, because of external forces, have a high incidence of backache. Sports where there is marked spinal movement, eg tennis, squash and gymnastics. Sports where the spine may be overloaded, eg weightlifting. Incidence: More common in young males. Sites: Usually found in the lumbar spine, but in Scheuermann’s Disease, dorsal spinal involvement may also occur. Pathology: There is a great deal of dispute about the exact pathology in back pain in sportsmen and back pain in general. Mechanical Back Pain 1. symptom complex which may be due to: muscle injury ligament injury facet joint injury discogenic disease without recognisable prolapse Lumbar disc lesion with or without sciatic nerve involvement. Spondylolysis and spondylolisthesis Other causes 2. ` Symptom: Low Back Pain 3 Signs: - Decreased spinal movement Pain on spinal movement Straight leg-raising test - positive Trigger spots which may reproduce radiation pain No neurological signs 4. Investigations: X-rays Usually negative but may show other pathology e.g. spondylolysis, fractures, facet joint degeneration or disc space narrowing. 5. Treatment: Conservative a. Rest is not acceptable to most athletes but they may need reduction of activity. b. Physiotherapy, including back and abdominal strengthening exercises c. Non-steroidal, anti-inflammatory drugs. d. Rarely, local anaesthetic and/or corticosteroid injections into trigger areas. Surgery There does not appear to be any indication for surgery in mechanical back pain except in lumbar facet syndrome. 6. Results Good results are usually achieved. Backache in Sportspersons Mechanism of Injury: Backache may occur in a number of sports due to overloading. It must be remembered that backache is the complaint in approximately 20% of all orthopaedic patients and that the pain may not be necessarily due to sport. Sports: Certain sports are more likely to cause backache than others. Contact sports, eg rugby and soccer, because of external forces, have a high incidence of backache. Sports where there is marked spinal movement, eg tennis, squash and gymnastics. Sports where the spine may be overloaded, eg weightlifting. Incidence: More common in young males. Sites: Usually found in the lumbar spine, but in Scheuermann’s Disease, dorsal spinal involvement may also occur. Pathology: There is a great deal of dispute about the exact pathology in back pain in sportsmen and back pain in general. Mechanical Back Pain 1. symptom complex which may be due to: muscle injury ligament injury facet joint injury discogenic disease without recognisable prolapse Lumbar disc lesion with or without sciatic nerve involvement. Spondylolysis and spondylolisthesis Other causes 2.  Symptom: Low Back Pain 3 Signs: - Decreased spinal movement Pain on spinal movement Straight leg-raising test - positive Trigger spots which may reproduce radiation pain No neurological signs 4. Investigations: X-rays Usually negative but may show other pathology e.g. spondylolysis, fractures, facet joint degeneration or disc space narrowing. 5. Treatment: Conservative a. Rest is not acceptable to most athletes but they may need reduction of activity. b. Physiotherapy, including back and abdominal strengthening exercises c. Non-steroidal, anti-inflammatory drugs. d. Rarely, local anaesthetic and/or corticosteroid injections into trigger areas. Surgery There does not appear to be any indication for surgery in mechanical back pain except in lumbar facet syndrome. 6. Results Good results are usually achieved.