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

  • Sports Medicine
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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.

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References

  1. Alexander J (1976) Effect of growth rate on the strength of the growth plate-shaft function. Skeletal Radiol 1:67–76. doi:10.1007/BF00347732

    Article  Google Scholar 

  2. Bahr R, Andersen SO, Loken S et al (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. doi:10.1097/01.BRS.0000096176.92881.37

    Article  PubMed  Google Scholar 

  3. Baranto A, Hellström M, Nyman R et al (2006) Back pain and degenerative abnormalities in the spine of young elite divers: a 5-year follow-up magnetic resonance imaging study. Knee Surg Sports Traumatol Arthrosc 14:907–914. doi:10.1007/s00167-005-0032-3

    Article  PubMed  Google Scholar 

  4. Caine D, Lindner K (1985) Overuse injuries of growing bones: the young female gymnast at risk? Physician Sports Med 13:51–64

    Google Scholar 

  5. Eriksson K, Nemeth G, Eriksson E (1996) Low back pain in elite cross-country skiers. A retrospective epidemiological study. Scand J Med Sci Sports 6:31–35

    Article  PubMed  CAS  Google Scholar 

  6. Fairbank JC, Couper J, Davies JB et al (1980) The Oswestry low back pain disability questionnaire. Physiotherapy 66:271–273

    PubMed  CAS  Google Scholar 

  7. Goldstein JD, Berger PE, Windler GE et al (1991) Spine injuries in gymnasts and swimmers. An epidemiologic investigation. Am J Sports Med 19:463–468. doi:10.1177/036354659101900507

    Article  PubMed  CAS  Google Scholar 

  8. Granhed H, Morelli B (1988) Low back pain among retired wrestlers and heavyweight lifters. Am J Sports Med 16:530–533. doi:10.1177/036354658801600517

    Article  PubMed  CAS  Google Scholar 

  9. Group E (1990) EuroQol—a new facility for the measurement of health-related quality of life. Health Policy 16:199–208. doi:10.1016/0168-8510(90)90421-9

    Article  Google Scholar 

  10. Harvey J, Tanner S (1991) Low back pain in young athletes. A practical approach. Sports Med 12:394–406. doi:10.2165/00007256-199112060-00005

    Article  PubMed  CAS  Google Scholar 

  11. Hellström M, Jacobsson B, Swärd L et al (1990) Radiologic abnormalities of the thoraco-lumbar spine in athletes. Acta Radiol 31:127–132

    Article  PubMed  Google Scholar 

  12. Jackson DW (1979) Low back pain in young athletes: evaluation of stress reaction and discogenic problems. Am J Sports Med 7:364–366. doi:10.1177/036354657900700614

    Article  PubMed  CAS  Google Scholar 

  13. Jackson DW, Wiltse LL, Cirincoine RJ (1976) Spondylolysis in the female gymnast. Clin Orthop Relat Res (117):68–73

  14. Kjaer P, Leboeuf-Yde C, Korsholm L et al (2005) Magnetic resonance imaging and low back pain in adults: a diagnostic imaging study of 40-year-old men and women. Spine 30:1173–1180. doi:10.1097/01.brs.0000162396.97739.76

    Article  PubMed  Google Scholar 

  15. Kozar B, Lord R (1983) Overuse injury in the young athlete: reasons for concern. Phys Sportsmed 11:116–122

    Google Scholar 

  16. Kujala UM, Kinnunen J, Helenius P et al (1999) Prolonged low-back pain in young athletes: a prospective case series study of findings and prognosis. Eur Spine J 8:480–484. doi:10.1007/s005860050209

    Article  PubMed  CAS  Google Scholar 

  17. Kujala UM, Taimela S, Erkintalo M et al (1996) Low-back pain in adolescent athletes. Med Sci Sports Exerc 28:165–170. doi:10.1097/00005768-199602000-00002

    PubMed  CAS  Google Scholar 

  18. Lundin O, Hellström M, Nilsson I et al (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  PubMed  CAS  Google Scholar 

  19. Modic M, Masaryk T, Ross J et al (1988) Imaging of degenerative disc disease. Radiology 168:177–186

    PubMed  CAS  Google Scholar 

  20. Mooney V, Cairns D, Robertson J (1976) A system for evaluating and treating chronic back disability. West J Med 124:370–376

    PubMed  CAS  Google Scholar 

  21. Sassmannshausen G, Smith BG (2002) Back pain in the young athlete. Clin Sports Med 21:121–132. doi:10.1016/S0278-5919(03)00061-9

    Article  PubMed  Google Scholar 

  22. Schmorl G, Junghanns H (1971) The human spine in health and disease. Editor Grune and Stratton, New York

    Google Scholar 

  23. Swärd L, Hellström M, Jacobsson B et al (1990) Acute injury of the vertebral ring apophysis and intervertebral disc in adolescent gymnasts. Spine 15:144–148. doi:10.1097/00007632-199002000-00021

    Article  PubMed  Google Scholar 

  24. Swärd L, Hellström M, Jacobsson B et al (1991) Disc degeneration and associated abnormalities of the spine in elite gymnasts. A magnetic resonance imaging study. Spine 16:437–443. doi:10.1097/00007632-199104000-00009

    Article  PubMed  Google Scholar 

  25. Swärd L, Hellström M, Jacobsson B et al (1990) Back pain and radiologic changes in the thoraco-lumbar spine of athletes. Spine 15:124–129. doi:10.1097/00007632-199002000-00015

    Article  PubMed  Google Scholar 

  26. Tertti M, Paajanen H, Kujala UM et al (1990) Disc degeneration in young gymnasts. A magnetic resonance imaging study. Am J Sports Med 18:206–208. doi:10.1177/036354659001800216

    Article  PubMed  CAS  Google Scholar 

  27. Videman T, Sarna S, Battie MC et al (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

    PubMed  CAS  Google Scholar 

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Acknowledgments

The authors acknowledge the financial support of The Medical Society of Göteborg, Sweden, Trygg-Hansa insurance company, The Research Council of the Swedish Sports Confederation (Centrum för idrottsforskning), Swedish Society of Spinal Surgeons/4S and Government grants under the LUA/ALF agreement. The authors acknowledge the assistance of the statistical advisor Anders Odén, PhD, Romelanda, Sweden. The authors thank radiology nurse P-A Svensson, Department of Radiology at Queen Silvia’s Children’s Hospital, Sahlgrenska University Hospital, Göteborg. The study was approved by the Regional Ethical Review Board in Gothenburg, Sweden. The experiments comply with the current laws in Sweden.

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Authors and Affiliations

  1. Department of Orthopaedics, University of Gothenburg and Sahlgrenska University Hospital, 413 45, Göteborg, Sweden

    Adad Baranto & Leif Swärd

  2. Department of Radiology, University of Gothenburg and Sahlgrenska University Hospital, Göteborg, Sweden

    Mikael Hellström

  3. Department of Radiology, Halmstad Hospital, Halmstad, Sweden

    C.-G. Cederlund

  4. Department of Radiology, Uppsala University, Uppsala, Sweden

    Rickard Nyman

Authors
  1. Adad Baranto
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  2. Mikael Hellström
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  3. C.-G. Cederlund
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  4. Rickard Nyman
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  5. Leif Swärd
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Corresponding author

Correspondence to Adad Baranto.

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Baranto, A., Hellström, M., Cederlund, CG. et al. Back pain and MRI changes in the thoraco-lumbar spine of top athletes in four different sports: a 15-year follow-up study. Knee Surg Sports Traumatol Arthrosc 17, 1125–1134 (2009). https://doi.org/10.1007/s00167-009-0767-3

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  • DOI: https://doi.org/10.1007/s00167-009-0767-3

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