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Chiropractic Research Review

Rehabilitation of Sports-Related LBP

The lifetime prevalence of low back pain (LBP) is 60 to 90%, and related medical costs exceed $25 billion annually. Many sports, especially those with combined movements (e.g. extension and rotation) or repetitive movements, can cause LBP.

Chronic LBP may be more prevalent than previously suspected: A recent study showed that LBP recurred in 86% of patients within one year, and that one year after initial symptoms, 48% continued to experience moderate-to-severe pain, and up to 25% continued to have limited activity.

This paper on managing LBP focused on the comprehensive treatment of sports-related LBP in cases lacking clear neurologic, spondylitic, or complicating symptoms, and the correction of faulty biomechanics. The major points of the review are presented as follows:

* Accurate diagnosis should include history, physical examination, and appropriate diagnostic studies.

* Initial treatment should include the following: education, pain control, relative rest and minor activity, and exercises inside pain-free range of motion.

* Later rehabilitation should involve restoration of full, pain-free range of motion; increasing leg flexibility; strengthening trunk muscles; aerobics; a return to normal activity and biomechanics; and prevention of recurring episodes.

The authors include a table of conditions and associated "diagnostic keys" to help determine specific lumbar problems in athletes. In conclusion, the authors note that "determination of clinically relevant pain generators in the lumbar spine is difficult," and that the "absence of symptoms does not imply normal function."

Drezner JA, Herring SA. Managing low back pain: Steps to optimize function and hasten return to activity. The Physician and Sportsmedicine, August 2001:29(8). Available at www.physsportsmed.com.

Chiropractic Research Review

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