MANAGEMENT OF BACK PAIN IN ATHLETES

Back pain affects millions of people. It affects 80% of the population and up to 52% at any given time. Back pain is not limited to sedentar y individuals; it has significant effects on athletes as well. Dependi ng upon the sport, incidence rates of back pain occur in athletes from 1.1% to as high as 30%. Athletes differ from the non-athletic populat ion in that their incentives to return to activity are considerably di fferent than non-athletes. The reasons may vary from the will to win t hrough to significant financial considerations. Although reasons for r ecovery are different, the physiology and mechanics of repair of injur ed soft tissue in the athlete is the same as for the non-athlete. Prop er management of the athlete requires ruling out emergent causes of ba ck pain such as tumour, infection, acute fracture, progressive neurolo gical deficit, visceral sources (e.g. pancreatitis, abdominal aortic a neurysm), and rheumatoid variants. Once a good history and physical is performed, a simple classification system can be utilised to manage t he athlete presenting with back pain. This system can be expressed as: (a) regional back pain; (b) radicular leg pain; (c) radicular leg pai n with progressive neurological deficit; and (d) cauda equina syndrome . Each of these categories needs to be managed in a specific manner an d can provide the healthcare professional with simple, straightforward guidelines for handling the athlete with lower back pain. The key is to return the athlete to the field of play in a safe and timely manner .