Skip to main content

Advertisement

SpringerLink
Log in

Low back pain in athletes and non-athletes: a group comparison of basic pain parameters and impact on sports activity

  • Original Article
  • Published:
Sport Sciences for Health Aims and scope Submit manuscript

Abstract

Introduction

Low back pain (LBP) is a major health issue in athletes and non-athletes often accompanied by considerable restrictions in everyday functioning. Knowledge about differences between those groups regarding LBP parameters (intensity, duration, and disability) and their influence on daily life is still lacking. Hence, the present study aimed at the comparison of those LBP parameters between athletes and non-athletes and the impact of these factors on sports activity.

Methods

LBP patients receiving prescribed sport- or physiotherapeutic treatment (N = 264) completed a questionnaire battery to determine their LBP pain intensity, duration, chronification, disability, and changes in sports activity. The categorization into athletes and non-athletes was based on performance level. Uni- and multivariate analyses of (Co-) variance and nonparametric group comparisons were executed to analyze group differences.

Results

Disability was lower in the athlete’s group, especially concerning work ability (p < 0.05). Athletes rather continued with their sports activity despite LBP (p < 0.001). The interaction between age and difference in training volume showed that non-athletes (<29 years) reported a greater reduction of training volume from a pain free to a LBP phase compared to athletes in the respective age group.

Conclusions

The results imply that athletes with LBP perceive less impairment than non-athletes concerning disability and changes in training volume. Possible explanations can be inferred from different socialization processes and pain coping mechanisms among athletes. The outcomes contribute to the existing literature by adding specific knowledge about dissimilarities between athletes and non-athletes regarding the appraisal of LBP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

LBP:

Low back pain

CPGS:

Chronic pain grade scale

DTV:

Difference in the training volume

ANCOVA:

Analysis of covariance

MANCOVA:

Multivariate analysis of covariance

M:

Mean

SD:

Standard deviation

References

  1. Murray CJL, Lopez AD (2013) Measuring the global burden of disease. N Engl J Med 369:448–457. doi:10.1056/NEJMra1201534

    Article  CAS  PubMed  Google Scholar 

  2. Balagué F, Mannion AF, Pellise F, Cedraschi C (2012) Non-specific low back pain. Lancet 379:482–491. doi:10.1016/S0140-6736(11)60610-7

    Article  PubMed  Google Scholar 

  3. Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, Woolf A, Vos T, Buchbinder R (2012) A systematic review of the global prevalence of low back pain. Arthritis Rheum 64:2028–2037. doi:10.1002/art.34347

    Article  PubMed  Google Scholar 

  4. Jonasson P, Halldin K, Karlsson J, Thoreson O, Hvannberg J, Sward L, Baranto A (2011) Prevalence of joint-related pain in the extremities and spine in five groups of top athletes. Knee Surg Sports Traumatol Arthrosc 19:1540–1546. doi:10.1007/s00167-011-1539-4

    Article  PubMed  Google Scholar 

  5. Machin MA, Hoare PN (2008) The role of workload and driver coping styles in predicting bus drivers’ need for recovery, positive and negative affect, and physical symptoms. Anxiety Stress Coping 21:359–375. doi:10.1080/10615800701766049

    Article  PubMed  Google Scholar 

  6. Hangai M, Kaneoka K, Okubo Y, Miyakawa S, Hinotsu S, Mukai N, Sakane M, Ochiai N (2010) Relationship between low back pain and competitive sports activities during youth. Am J Sports Med 38:791–796. doi:10.1177/0363546509350297

    Article  PubMed  Google Scholar 

  7. Videman T, Sarna S, Battie MC, Koskinen S, Gill K, Paananen H, Gibbons L (1995) The long-term effects of physical loading and exercise lifestyles on back-related symptoms, disability, and spinal pathology among men. Spine 20:699–709. doi:10.1097/00007632-199503150-00011

    Article  CAS  PubMed  Google Scholar 

  8. Bahr R, Andersen SO, Loken S, Fossan B, Hansen T, Holme I (2004) Low back pain among endurance athletes with and without specific back loading–a cross-sectional survey of cross-country skiers, rowers, orienteerers, and nonathletic controls. Spine 29:449–454

    Article  PubMed  Google Scholar 

  9. Lundin O, Hellstrom M, Nilsson I, Sward L (2001) Back pain and radiological changes in the thoraco-lumbar spine of athletes. A long-term follow-up. Scand J Med Sci Sports 11:103–109. doi:10.1034/j.1600-0838.2001.011002103.x

    Article  CAS  PubMed  Google Scholar 

  10. Hoskins W, Pollard H, Daff C, Odell A, Garbutt P, McHardy A, Hardy K, Dragasevic G (2009) Low back pain status in elite and semi-elite Australian football codes: a cross-sectional survey of football (soccer), Australian rules, rugby league, rugby union and non-athletic controls. BMC Musculoskelet Disord 10:38. doi:10.1186/1471-2474-10-38

    Article  PubMed  PubMed Central  Google Scholar 

  11. Azevedo DC, Samulski DM (2003) Assessment of psychological pain management techniques: a comparative study between athletes and non-athletes. Rev Bras Med Esporte 9:214–222. doi:10.1590/S1517-86922003000400003

    Article  Google Scholar 

  12. Sato T, Ito T, Hirano T, Morita O, Kikuchi R, Endo N, Tanabe N (2011) Low back pain in childhood and adolescence: assessment of sports activities. Eur Spine J 20:94–99. doi:10.1007/s00586-010-1485-8

    Article  PubMed  Google Scholar 

  13. Fritz JM, Clifford SN (2010) Low back pain in adolescents: a comparison of clinical outcomes in sports participants and non-participants. J Athl Train 45:61–66. doi:10.4085/1062-6050-45.1.61

    Article  PubMed  PubMed Central  Google Scholar 

  14. Foss IS, Holme I, Bahr R (2012) The prevalence of low back pain among former elite cross-country skiers, rowers, orienteerers, and non-athletes: a 10-year cohort study. Am J Sports Med 40:2610–2616. doi:10.1177/0363546512458413

    Article  PubMed  Google Scholar 

  15. Tunas P, Nilstad A, Myklebust G (2015) Low back pain in female elite football and handball players compared with an active control group. Knee Surg Sports Traumatol Arthrosc 23:2540–2547. doi:10.1007/s00167-014-3069-3

    Article  PubMed  Google Scholar 

  16. Lin CW, McAuley JH, Macedo L, Barnett DC, Smeets RJ, Verbunt JA (2011) Relationship between physical activity and disability in low back pain: a systematic review and meta-analysis. Pain 152:607–613. doi:10.1016/j.pain.2010.11.034

    Article  PubMed  Google Scholar 

  17. Plaas H, Sudhaus S, Willburger R, Hasenbring MI (2014) Physical activity and low back pain: the role of subgroups based on the avoidance-endurance model. Disabil Rehabil 36:749–755. doi:10.3109/09638288.2013.814723

    Article  PubMed  Google Scholar 

  18. Soderman K, Adolphson J, Lorentzon R, Alfredson H (2001) Injuries in adolescent female players in European football: a prospective study over one outdoor soccer season. Scand J Med Sci Sports 11:299–304. doi:10.1034/j.1600-0838.2001.110508.x

    Article  CAS  PubMed  Google Scholar 

  19. Peterson L, Junge A, Chomiak J, Graf-Baumann T, Dvorak J (2000) Incidence of football injuries and complaints in different age groups and skill-level groups. Am J Sports Med 28:51–57. doi:10.1177/28.suppl_5.S-51

    Article  Google Scholar 

  20. Legault ÉP, Descarreaux M, Cantin V (2015) Musculoskeletal symptoms in an adolescent athlete population: a comparative study. BMC Musculoskelet Disord 16:210. doi:10.1186/s12891-015-0681-4

    Article  PubMed  PubMed Central  Google Scholar 

  21. Downie A, Williams CM, Henschke N, Hancock MJ, Ostelo RW, de Vet HC, Macaskill P, Irwig L, van Tulder MW, Koes BW, Maher CG (2014) Red flags to screen for malignancy and fracture in patients with low back pain. Br J Sports Med 48:1518. doi:10.1136/bjsports-2014-f7095rep

    Article  PubMed  Google Scholar 

  22. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A (2007) Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 39:1423–1434. doi:10.1249/mss.0b013e3180616b27

    Article  PubMed  Google Scholar 

  23. De Pauw K, Roelands B, Cheung SS, de Geus B, Rietjens G, Meeusen R (2013) Guidelines to classify subject groups in sport-science research. Int J Sports Physiol Perform 8:111–122

    Article  PubMed  Google Scholar 

  24. Klasen BW, Hallner D, Schaub C, Willburger R, Hasenbring M (2004) Validation and reliability of the German version of the chronic pain grade questionnaire in primary care back pain patients. Psychosoc Med 1:1–12

    Google Scholar 

  25. Aggarwal CC (2013) Outlier Analysis. Springer, New York

    Book  Google Scholar 

  26. Pickering G, Jourdan D, Eschalier A, Dubray C (2002) Impact of age, gender and cognitive functioning on pain perception. Gerontology 48:112–118. doi:10.1159/000048937

    Article  PubMed  Google Scholar 

  27. Grimmer K, Williams M (2000) Gender-age environmental associates of adolescent low back pain. Appl Ergon 31:343–360. doi:10.1016/S0003-6870(00)00002-8

    Article  CAS  PubMed  Google Scholar 

  28. Wiesenfeld-Hallin Z (2005) Sex differences in pain perception. Gend Med 2:137–145. doi:10.1016/S1550-8579(05)80042-7

    Article  PubMed  Google Scholar 

  29. Miller GA, Chapman JP (2001) Misunderstanding analysis of covariance. J Abnorm Psychol 110:40–48. doi:10.1037/0021-843X.110.1.40

    Article  CAS  PubMed  Google Scholar 

  30. Koes BW, van Tulder MW, Thomas S (2006) Diagnosis and treatment of low back pain. Brit Med J 332:1430–1434. doi:10.1136/bmj.332.7555.1430

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Tesarz J, Schuster AK, Hartmann M, Gerhardt A, Eich W (2012) Pain perception in athletes compared to normally active controls: a systematic review with meta-analysis. Pain 153:1253–1262. doi:10.1016/j.pain.2012.03.005

    Article  PubMed  Google Scholar 

  32. Roland M, Morris R (1983) A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain. Spine 8:141–144

    Article  CAS  PubMed  Google Scholar 

  33. Imamura M, Chen J, Matsubayashi SR, Targino RA, Alfieri FM, Bueno DK, Hsing WT (2013) Changes in pressure pain threshold in patients with chronic nonspecific low back pain. Spine 38:2098–2107. doi:10.1097/01.brs.0000435027.50317.d7

    Article  PubMed  Google Scholar 

  34. Ryan ED, Kovacic CR (1966) Pain tolerance and athletic participation. Percept Mot Skills 22:383–390. doi:10.2466/pms.1966.22.2.383

    Article  Google Scholar 

  35. Raudenbush B, Canter RJ, Corley N, Grayhem R, Koon J, Lilley S, Meyer B, Wilson I (2012) Pain threshold and tolerance differences among intercollegiate athletes: implication of past sports injuries and willingness to compete among sports teams. N Am J Psychol 14:85–94

    Google Scholar 

  36. Ng CC (2009) Experimentally induced mechanical pain threshold and tolerance difference between competitive contact and non-contact sports male athletes [master thesis]. Nanyang Technological University, Singapore

    Google Scholar 

  37. Ryan ED, Foster R (1967) Athletic participation and perceptual augmentation and reduction. J Pers Soc Psychol 6:472–476. doi:10.1037/h0021226

    Article  CAS  PubMed  Google Scholar 

  38. Nixon HL (1992) A social network analysys of influences on athletes to play with pain and injuries. J Spo Soc Issues 16:127–135. doi:10.1177/019372359201600208

    Article  Google Scholar 

  39. Deroche T, Woodman T, Stephan Y, Brewer BW, Le Scanff C (2011) Athletes’ inclination to play through pain: a coping perspective. Anxiety Stress Coping 24:579–587. doi:10.1080/10615806.2011.552717

    Article  PubMed  Google Scholar 

  40. O’Neill S, Manniche C, Graven-Nielsen T, Arendt-Nielsen L (2014) Association between a composite score of pain sensitivity and clinical parameters in low-back pain. Clin J Pain 30:831–838. doi:10.1097/ajp.0000000000000042

    Article  PubMed  Google Scholar 

  41. Kukull WA, Ganguli M (2012) Generalizability: the trees, the forest, and the low-hanging fruit. Neurology 78:1886–1891. doi:10.1212/WNL.0b013e318258f812

    Article  PubMed  PubMed Central  Google Scholar 

  42. Sharma P, Sandhu JS, Shenoy S (2011) Variation in the response to pain between athletes and non-athletes. Ibnosina J Med BS 3:165–171

    Google Scholar 

  43. Tesarz J, Gerhardt A, Schommer K, Treede RD, Eich W (2013) Alterations in endogenous pain modulation in endurance athletes: an experimental study using quantitative sensory testing and the cold-pressor task. Pain 154:1022–1029. doi:10.1016/j.pain.2013.03.014

    Article  PubMed  Google Scholar 

  44. Sullivan MJL, Tripp DA, Rodgers WM, Stanish W (2000) Catastrophizing and pain perception in sport participants. J Appl Sport Psychol 12:151–167. doi:10.1080/10413200008404220

    Article  Google Scholar 

  45. Haljaste K, Unt E (2010) Relationships between physical activity and musculoskeletal disorders in former athletes. Coll Antropol 34:1335–1340

    PubMed  Google Scholar 

  46. Müller J, Müller S, Stoll J, Fröhlich K, Otto C, Mayer F (2016) Back pain prevalence in adolescent athletes. Scand J Med Sci Sports. doi:10.1111/sms.12664

    Google Scholar 

  47. Morgan SL, Harding DJ (2006) Matching estimators of causal effects: prospects and pitfalls in theory and practice. Sociol Method Res 35:3–60. doi:10.1177/0049124106289164

    Article  Google Scholar 

  48. Silverberg JI (2015) Study designs in dermatology: a review for the clinical dermatologist. J Am Acad Dermatol 73:721–731. doi:10.1016/j.jaad.2014.08.029

    Article  PubMed  Google Scholar 

  49. Von Korff M, Barlow W, Cherkin D, Deyo RA (1994) Effects of practice style in managing back pain. Ann Intern Med 121:187–195. doi:10.7326/0003-4819-121-3-199408010-00005

    Article  Google Scholar 

Download references

Acknowledgments

The present study was initiated and funded by the German Federal Institute of Sport Science (IIA1–080102B/11–14). The research was realized within MiSpEx—The National Research Network for Medicine in Spine Exercise.

Author information

Authors and Affiliations

  1. Unit of Sport Psychology, Faculty of Sport Science, Ruhr University, Bochum, North Rhine-Westphalia, Germany

    Jahan Heidari, Tobias Mierswa & Michael Kellmann

  2. Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University, Bochum, North Rhine-Westphalia, Germany

    Monika Hasenbring & Claudia Levenig

  3. Department of Health and Social Psychology, Institute of Psychology, German Sport University, Cologne, North Rhine-Westphalia, Germany

    Jens Kleinert & Ida Ott

  4. School of Human Movement and Nutrition Science, The University of Queensland, St Lucia, Australia

    Michael Kellmann

Authors
  1. Jahan Heidari
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tobias Mierswa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Monika Hasenbring
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jens Kleinert
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Claudia Levenig
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ida Ott
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michael Kellmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jahan Heidari.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Heidari, J., Mierswa, T., Hasenbring, M. et al. Low back pain in athletes and non-athletes: a group comparison of basic pain parameters and impact on sports activity. Sport Sci Health 12, 297–306 (2016). https://doi.org/10.1007/s11332-016-0288-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11332-016-0288-7

Keywords

Search

Navigation