The Most Common Causes of Back Pain in Sports

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Published on Monday, 22 March 2010 01:06

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Jonny Wood, PA-C, Author Bio

Back pain is extremely common and effects 60 to 85% of adults. It is a frequent issue among athletes and can be the result of any number of issues.
The conditions explained in this article represent the most common etiologies of back pain in the athlete and are not, by any stretch, representative of a complete catalog.

In addition to the physical exam, X-rays, and other imaging such as an MRI may be needed to evaluate the cause of your pain.

Back Pain: Muscle Strains

The most prevalent injury causing back pain is muscle strain. In almost all sports, our backs are continually at work--moving, twisting, supporting the body, frequently against resistance.

When back muscles are stressed beyond their range-of-motion (ROM), strain injuries result. Strain injuries are defined as a small tearing of the muscle tissue that provokes a self-perpetuating cycle of inflammation, pain and weakness unless treated appropriately.

Treatment:

• Rest: refrain from heavy lifting, unnecessary bending twisting activities, or any activity that stresses the involved muscles.
• Ice: helps calm inflammation and spasm
• Anti-inflammatory medication: talk to your doctor about appropriate medications such as Advil, ibuprofen, Motrin, Aleve and their respective dosages
• Muscle Relaxants
• Physical Therapy

Back Pain: Sacroiliitis/SI joint pain

Sacroillac Joint

The sacroiliac joints are small “joints” between the low back and the pelvis. These areas are often irritated by jarring type of injuries that occur in sports such as football or running. Injuries of this type can also be caused by muscular imbalances of the hip and low back muscles--some muscles may be too tight or others too weak.

During a physical exam, the pain is localized to the SI joints, usually without other symptoms. The examining provider can sometimes detect some very slight rotation of the pelvis causing the inflammation.

Treatment:

• Rest, Ice, anti-inflammatories
• Physical Therapy: to correct any pelvic rotation and to establish a focused exercise program designed to maintain the corrected posture
• Possible corticosteroid (cortisone) injection

What is the source of your back pain?

Back Pain: Facet Joint Pain

There are very tiny joints formed at the points where two vertebrae articulate with one another.

Aggravating activities for these areas are repetitive lumbar extension/hyperextension (leaning backwards) as in gymnastics or a sudden forceful hyperextension mechanism as football or wrestling.

Having poor core/abdominal strength is a huge risk factor for developing facet joint dysfunction.

Treatment:

• Rest (avoiding hyperextension of the spine), ice, anti-inflammatories
• Physical Therapy: to establish a focused exercise program designed to alleviate stress to the facet joints
• Possible corticosteroid (cortisone) injection

Back Pain: Spondylolysis & Spondylolesthesis

Spondylolysis is a condition wherein a specific part of the vertebra called the pars interarticularis is cracked. Like facet joint pain, this is caused by repetitive hyperextension and compression of the spine that happens in sports such as gymnastics or weight lifting. Or or a sudden hyperextension injury in sports like wrestling or football.

When both sides of the vertebra are broken at the same time, the bone is then free to move forward or backward. When this happens, it is termed spondylolesthesis (see pic).

Treatment:

• Rest (avoiding hyperextension of the spine)
• Ice
• Anti-inflammatories
• Physical Therapy: to establish a focused exercise program designed to alleviate stress to the facet joints
• Surgery may be required if slippage is too great.

Back Pain: Sciatica and Sciatic Nerve

Sciatica is an umbrella term used to describe pain in the posterior hip that radiates down into the leg, often to the outside foot and toes. It can be caused by several processes--all of which result in the compression of the sciatic nerve and enormously painful.

1. Piriformis Syndrome: The piriformis muscle (a muscle deep in the hip) becomes tight and compresses the nerve – frequently seen in runners
2. Foramenal Stenosis: caused by arthritis in the back around the nerve as it exists the spinal cord, a herniated disc in the back that pushes on the sciatic nerve (common in weight lifting), or a significant spondylolesthesis wherein the shifted vertebra compresses the nerve.
3. There are other non-sports related causes of sciatica, which are beyond the scope of this article (tumors, etc).

Treatment:

• Rest, Ice, Anti-inflammatories, physical therapy, steroid injection, and surgery to decompress the nerve.
• Having a thorough examination and workup by a trained sports medicine provider is critical to ensure proper diagnosis and treatment.