Low back pain in the aging athlete.

Low back pain has an incidence between 1% and 30% in athletes. The natural history of low back pain is such that greater than 90% will improve without medical attention. Our treatment algorithm begins by ruling out nonspinal related causes of low back pain including neoplasm, infection, and serious medical conditions. Next cauda equina compression is differentiated from clinical entities that can be treated on an elective basis. Low back strain, herniated nucleus pulposis, spinal stenosis, and degenerative disease are each discussed with an emphasis on imaging studies finding a correlation between history, physical, and the neurodiagnostic testing. Athletes over the age of 60 who require back surgery should understand that they would most likely not return to their previous level of activity. Recent work has focused on rehabilitative principles such as core stabilization and their role in the prevention and treatment of athletes with lumbar disorders.

Epidemiology of back pain in the athlete.

Back pain and injuries are common complaints of athletes. The nature of the sport involved with the specific stresses that it places on the athlete's spine may play a role in the injuries incurred. These injuries may limit an athlete's function and hinder performance; however, the majority of these insults are self-limiting and respond well to conservative measures. Based on the epidemiologic data, it appears that possibly the single most important step in reducing the back pain experienced by athletes would involve the performance of a structured back-strengthening program. Such a plan might reduce the most common diagnostic entities encountered by the athlete with back pain.