Risk Factors Associated With Low Back Pain in Golfers: A Systematic Review and Meta-analysis.

ABSTRACT

CONTEXT Low back pain is common in golfers. The risk factors for golf-related low back pain are unclear but may include individual demographic, anthropometric, and practice factors as well as movement characteristics of the golf swing. OBJECTIVE: The aims of this systematic review were to summarize and synthesize evidence for factors associated with low back pain in recreational and professional golfers. DATA SOURCES A systematic literature search was conducted using the PubMed, CINAHL, and SPORTDiscus electronic databases through September 2017. STUDY SELECTION Studies were included if they quantified demographic, anthropometric, biomechanical, or practice variables in individuals with and without golf-related low back pain. STUDY DESIGN: Systematic review and meta-analysis. LEVEL OF EVIDENCE Level 3. DATA EXTRACTION Studies were independently reviewed for inclusion by 2 authors, and the following data were extracted characterization of low back pain, participant demographics, anthropometrics, biomechanics, strength/flexibility, and practice characteristics. The methodological quality of studies was appraised by 3 authors using a previously published checklist. Where possible, individual and pooled effect sizes of select variables of interest were calculated for differences between golfers with and without pain. RESULTS: The search retrieved 73 articles, 19 of which met the inclusion criteria (12 case-control studies, 5 cross-sectional studies, and 2 prospective longitudinal studies). Methodological quality scores ranged from 12.5% to 100.0%. Pooled analyses demonstrated a significant association between increased age and body mass and golf-related low back pain in cross-sectional/case-control studies. Prospective data indicated that previous history of back pain predicts future episodes of pain. CONCLUSION: Individual demographic and anthropometric characteristics may be associated with low back pain, but this does not support a relationship between swing characteristics and the development of golf-related pain. Additional high-quality prospective studies are needed to clarify risk factors for back pain in golfers.