Epidemiology and Risk Factors of Low Back Pain in Athletes
Summary
Low back pain is one of the most common musculoskeletal complaints among athletes, with lifetime prevalence estimates ranging from around 50% to over 90% depending on sport and level of competition. Epidemiological studies reveal that endurance and loading sports such as rowing, skiing and gymnastics often report the highest rates of lumbar pain, while team sports show more variable figures. Risk factors span several domains: biomechanical (limited spinal mobility, muscle imbalance, poor pelvic alignment), training-related (rapid increases in volume or intensity, high acute:chronic workload ratios), individual (previous episode of low back pain, body composition, flexibility deficits) and psychosocial (stress, recovery practices). Across diverse cohorts—from adolescent equestrians to elite team athletes—consistent associations emerge between excessive repetitive loading or inadequate conditioning of trunk stabilisers and the onset or recurrence of lumbar symptoms. Preventive strategies emphasise dose-controlled training, core endurance development, flexibility optimisation and monitoring of recovery markers. Globally, these findings underpin targeted screening and early intervention programmes aimed at reducing time loss and enhancing long-term athlete welfare.
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Epidemiology and Risk Factors of Low Back Pain in Athletes publication trend
The graph below shows the total number of articles in epidemiology and risk factors of low back pain in athletes across all publications each year (not limited to Nature Index journals).
Technical terms
Point prevalence: the proportion of athletes reporting low back pain at a specific moment in time.
Acute:Chronic Workload Ratio (ACWR): a metric comparing recent training load (acute) with an athlete’s longer-term average (chronic).
Hamstring extensibility: the range of motion achievable through hamstring muscle length before resistance or discomfort.
Sagittal pelvic tilt: the orientation of the pelvis in the sagittal plane, influencing lumbar spinal curvature and load distribution.
References
- Prevalence of Back Pain in Sports: A Systematic Review of the Literature. Sports Medicine (2016).
- Low Back Pain in Athletes Is Associated with General and Sport Specific Risk Factors: A Comprehensive Review of Longitudinal Studies. Rehabilitation Research and Practice (2015).
- Trunk Lateral Flexor Endurance and Body Fat: Predictive Risk Factors for Low Back Pain in Child Equestrian Athletes. Children (2020).
- Absence of Injury Is Not Absence of Pain: Prevalence of Preseason Musculoskeletal Pain and Associated Factors in Collegiate Soccer and Basketball Student Athletes. International Journal of Environmental Research and Public Health (2022).
- Is There a Relationship Between Workload and Occurrence of Back Pain and Back Injuries in Athletes?. Frontiers in Physiology (2020).
- The Potential Role of Hamstring Extensibility on Sagittal Pelvic Tilt, Sagittal Spinal Curves and Recurrent Low Back Pain in Team Sports Players: A Gender Perspective Analysis. International Journal of Environmental Research and Public Health (2021).
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