Back pain and MRI abnormalities in the thoraco-lumbar spine of elite long distance runners. A cross sectional study.
Main Article Content
Abstract
Study design
Observational cross-sectional study. Level of evidence 3.
Objective
The objective was to investigate the amount of MRI abnormalities in the thoraco-lumbar
spine and the prevalence of back pain in male elite long distance runners compared to a
control group of non-athletes in the corresponding age.
Summary of Background
Studies have shown that athletes have a higher prevalence of back pain and a greater
number of spinal abnormalities on MRI, such as disc degeneration, compared to non-
athletes. The associations between running and both back pain and spinal MRI abnormalities
have not been clarified.
Data
Study participants were 22 male elite long distance runners (runner group) and 25 male non-
athletes (control group) of 18-28 years of age.
Methods
Back pain was assessed by a three part self-reported questionnaire. Sagittal T1 and T2
weighted MRI examinations from Th5 to sacrum was conducted to evaluate MRI
abnormalities according to study protocol.
Results
The runners reported a significant higher prevalence of back pain (45%), compared to the
control group (12%) (P=0.011). No statistical significant difference was found in amount of
MRI verified spinal abnormalities (P=0.614) or type of abnormalities between the groups. No
statistically significant correlation between back pain and MRI abnormalities was
established.
Conclusions
Elite level male long distance runners have a significant higher prevalence of back pain but
demonstrate no significant difference in the amount or type of spinal abnormalities
compared to non-athletes. Further prospective studies are needed to validate the results.
Keywords
Running, Low back Pain, young adult, Magnetic resonance imaging, intervertebral disc
displacement, athletes, sports, physical loading, cross sectional studies.
Article Details
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
Arkin, A. M., & Katz, J. F. (1956). The effects of pressure on epiphyseal growth; the mechanism of plasticity of growing bone. J Bone Joint Surg Am, 38-A(5), 1056-1076.
Bahr, R., Andersen, S. O., 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 (Phila Pa 1976), 29(4), 449-454.
Baranto, A., Hellstrom, M., Cederlund, C. G., Nyman, R., & Sward, L. (2009). 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(9), 1125-1134. doi: 10.1007/s00167-009-0767-3
Baranto, A., Hellstrom, M., Nyman, R., Lundin, O., & Sward, L. (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(9), 907-914. doi: 10.1007/s00167-005-0032-3
Bono, C. M. (2004). Low-back pain in athletes. J Bone Joint Surg Am, 86-A(2), 382-396.
Ferguson, R. J., McMaster, J. H., & Stanitski, C. L. (1974). Low back pain in college football linemen. J Sports Med, 2(2), 63-69.
Foss, I. S., Holme, I., & Bahr, R. (2012). The prevalence of low back pain among former elite cross-country skiers, rowers, orienteerers, and nonathletes: a 10-year cohort study. Am J Sports Med, 40(11), 2610-2616. doi: 10.1177/0363546512458413
Goldstein, J. D., Berger, P. E., Windler, G. E., & Jackson, D. W. (1991). Spine injuries in gymnasts and swimmers. An epidemiologic investigation. Am J Sports Med, 19(5), 463-468.
Granhed, H., & Morelli, B. (1988). Low back pain among retired wrestlers and heavyweight lifters. Am J Sports Med, 16(5), 530-533.
Hainline, B. (1995). Low back injury. Clin Sports Med, 14(1), 241-265.
Hangai, M., Kaneoka, K., Hinotsu, S., Shimizu, K., Okubo, Y., Miyakawa, S., . . . Ochiai, N. (2009). Lumbar intervertebral disk degeneration in athletes. Am J Sports Med, 37(1), 149-155. doi: 10.1177/0363546508323252
Hangai, M., Kaneoka, K., Okubo, Y., Miyakawa, S., Hinotsu, S., Mukai, N., . . . Ochiai, N. (2010). Relationship between low back pain and competitive sports activities during youth. Am J Sports Med, 38(4), 791-796. doi: 10.1177/0363546509350297
Haus, B. M., & Micheli, L. J. (2012). Back pain in the pediatric and adolescent athlete. Clin Sports Med, 31(3), 423-440. doi: 10.1016/j.csm.2012.03.011
Hellstrom, M., Jacobsson, B., Sward, L., & Peterson, L. (1990). Radiologic abnormalities of the thoraco-lumbar spine in athletes. Acta Radiol, 31(2), 127-132.
Hubbard, D. D. (1974). Injuries of the spine in children and adolescents. Clin Orthop Relat Res(100), 56-65.
Jackson, D. W., Wiltse, L. L., & Cirincoine, R. J. (1976). Spondylolysis in the female gymnast. Clin Orthop Relat Res(117), 68-73.
Kujala, U. M., Taimela, S., Erkintalo, M., Salminen, J. J., & Kaprio, J. (1996). Low-back pain in adolescent athletes. Med Sci Sports Exerc, 28(2), 165-170.
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(2), 103-109.
Mautner, K. R., & Huggins, M. J. (2012). The young adult spine in sports. Clin Sports Med, 31(3), 453-472. doi: 10.1016/j.csm.2012.03.007
McCarroll, J. R., Miller, J. M., & Ritter, M. A. (1986). Lumbar spondylolysis and spondylolisthesis in college football players. A prospective study. Am J Sports Med, 14(5), 404-406.
Micheli, L. J., & Wood, R. (1995). Back pain in young athletes. Significant differences from adults in causes and patterns. Arch Pediatr Adolesc Med, 149(1), 15-18.
Pfirrmann, C. W., Metzdorf, A., Zanetti, M., Hodler, J., & Boos, N. (2001). Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine (Phila Pa 1976), 26(17), 1873-1878.
Schmidt, C. P., Zwingenberger, S., Walther, A., Reuter, U., Kasten, P., Seifert, J., . . . Stiehler, M. (2014). Prevalence of low back pain in adolescent athletes - an epidemiological investigation. Int J Sports Med, 35(8), 684-689. doi: 10.1055/s-0033-1358731
Skoffer, B., & Foldspang, A. (2008). Physical activity and low-back pain in schoolchildren. Eur Spine J, 17(3), 373-379. doi: 10.1007/s00586-007-0583-8
Sward, L., Hellstrom, M., Jacobsson, B., Nyman, R., & Peterson, L. (1990). Acute injury of the vertebral ring apophysis and intervertebral disc in adolescent gymnasts. Spine (Phila Pa 1976), 15(2), 144-148.
Sward, L., Hellstrom, M., Jacobsson, B., Nyman, R., & Peterson, L. (1991). Disc degeneration and associated abnormalities of the spine in elite gymnasts. A magnetic resonance imaging study. Spine (Phila Pa 1976), 16(4), 437-443.
Sward, L., Hellstrom, M., Jacobsson, B., & Peterson, L. (1990). Back pain and radiologic changes in the thoraco-lumbar spine of athletes. Spine (Phila Pa 1976), 15(2), 124-129.
Tertti, M., Paajanen, H., Kujala, U. M., Alanen, A., Salmi, T. T., & Kormano, M. (1990). Disc degeneration in young gymnasts. A magnetic resonance imaging study. Am J Sports Med, 18(2), 206-208.
Thoreson, O., Baranto, A., Ekstrom, L., Holm, S., Hellstrom, M., & Sward, L. (2010). The immediate effect of repeated loading on the compressive strength of young porcine lumbar spine. Knee Surg Sports Traumatol Arthrosc, 18(5), 694-701. doi: 10.1007/s00167-009-1001-z