Low Back Pain in Athletes
The second most common medical complaint is back pain and related symptoms, second only to the common cold. The lifetime prevalence of back pain is around 80%, with the 45-64 age bracket experiencing the highest prevalence.
Natural history of low back pain
The natural history of acute low back pain is similar to sciatica, which is pain and inflammation of the sciatica nerve in the thigh and leg. Recovery periods vary from individual to individual, however, commonly:
- 60% of people recovering in 1-3 weeks
- 90% recovering in 6-8 weeks
- 96% recovering in 12 weeks
While the more serious cases of lower back pain, for example cancer or infection, are uncommon and occur within less than 1% of people.
Causes of low back pain
The cause of low back pain is often the result of mechanical damage due to poor posture, such as those who have sitting based occupations and inadequate conditioning. Other causes can be daily stresses, such as sneezing, coughing or bending over, which can result in a herniated disc. Those who work at a desk, and therefore sit all day, have a higher chance of herniating a disc.
Intradiscal pressure is greatest when sitting as the disc experiences pressure on the thinnest, least supported area of the annulus fibrosus, which is the supporting ligament. This causes the disc to herniate.
Mechanical low back pain can be referred to as pain secondary to deformity of anatomic structure, injury or overuse of a normal anatomic structure. Static loading of the spine (which refers to a prolonged period of sitting or standing), certain activities (such as bending forward and sweeping) can aggravate low back pain. This pain is alleviated when multidirectional forces, such as walking or when it is horizontal balances the spine.
Mechanical conditions are responsible for 98% of back pain cases, including; spinal stenosis, disc herniation, back strain, osteoarthritis and disc disease.
Treatment of low back pain
The first step of treating and managing low back pain is a consultation with a chiropractor and physiotherapist. At Sydney Spine & Sports Centre (S3C) our chiropractors and physiotherapists will initially take a physical examination and full medical history. For some patients, an x-ray may be arranged, although not all. This is assessed on a case-by-case basis based on the information from the physical examination and the patient’s history, in collaboration with specific guidelines.
Most patients can start therapy with one of our chiropractors or physiotherapists without having had an x-ray, MRI or CT scan. Though, radiography is useful in determining alternations in the lumbar spine (low back). Chiropractors and physiotherapists use this data to formulate a diagnosis and develop a treatment plan.
Through controlled physical activity and non-addictive anti-inflammatory medication, chiropractic treatments and physiotherapy treatments most patients will improve the severity of their low back pain. While treatment through surgery is a last resort for patients who have not shown improvement on conservative therapy (chiropractic and physiotherapy) and have signs of sciatica, that is associated to a herniated disc.
Chronic low back pain is a complex disorder though it can be managed with a multidisciplinary approach and fortunately it only affects a small number of patients.
When our chiropractors and physiotherapists at Sydney Spine & Sports Centre (S3C) are asked on the best advice for preventing low back pain, the following are initially stated. Getting physically fit and quitting smoking is the best way to prevent back pain, as obesity and smoking are associated with the causes of low back pain. Back pain can be reduced with ergonomic intervention, physical activity and learning more about what prevents it. Please call either our Balmain or Dee Why chiropractic and physiotherapy clinics for more information.
Spine injury and back pain disorders are less likely to be experienced by those who regularly exercise. This is because they have more strength and flexibility for supporting structures, such as flexible gluteal and hamstring muscles and strong abdominal and lumbar paraspinal muscles.
Only 10% of athletes experience problems involving the lumbar spine. Those athletes who compete in gymnastics and football have a higher chance of associated lumbar spine problems because of repetitive activities, such as twisting and bending motions. These injuries respond effectively to chiropractic and physiotherapy treatment, because they are minor. While athletes who only train casually, such as on weekends, experience a higher risk of lumbar spine problems, due to their fitness levels. It is recommended that strength and conditioning is improved based on the functions of the given sport and technique modifications where necessary to assist in the prevention of low back pain.