Centro de la columna Vertebral: November 27, 2015
The correlation between the degenerated intervertebral disc and low back pain remains uncertain. The high frequency of imaging findings in the general population of degenerated lumbar discs in asymptomatic individuals is evidence against the required cause-and-effect relationship
Each sport makes involves particular demands to the lumbar spine, and therefore, on the intervertebral discs. It must be taken into account that great forces are developed on the disc during sports maneuvers.
Great compressive forces can also be developed in sports such as bowling, cricket, baseball, and tennis, which can be diminished with proper training.
In sports such as American football, the lumbar spine can register compressive loads of more than 8,600 newtons, exposing these athletes to repetitive micro-traumas.
But the sport where the highest concentration of compressive forces on the lumbar spine is found is in weightlifting, in which the average compressive forces can be greater than 17,000 newtons (although this group of athletes is not the one that reports the highest rate of low back pain frequency), mainly in the discs of level L4/L5, although the degenerative disc process can be found in these athletes in the high lumbar levels, while in soccer players the finding is concentrated in the spaces from L4 to S1.
Remember that one Newton unit is equivalent to approximately 100 grams [N = 0.1 k].
Some studies have suggested an association between specific radiographic findings and the likelihood of developing low back pain.
. The radiographic finding that was most frequently related to low back pain was the decrease in the height of the intervertebral space, regardless of whether it was detected at the beginning of the study or in the follow-up.
Furthermore, the more levels involved, the greater the likelihood that athletes will suffer from low back pain.
It has also been found that decreased signal intensity in lumbar intervertebral discs in MRI studies correlates with low back pain in both athletes and non-athletes, as well as that an abnormal vertebral configuration (defined as an increase in the anterior-posterior diameter, presumably due to the formation of an osteophyte), and the degeneration of the cartilaginous plates of the vertebral bodies, also correlate with an increased risk of low back pain.
The conservative treatment for low back pain of discogenic origin is mainly focused on physical medicine protocols, individualizing the characteristics of each sport, while infiltration or intradiscal injections are a controversial issue.
Despite the absence of specific evidence, epidural steroid application continues to be a popular option, although there have been no reports of efficacy in athletes to date. Other options, such as intradiscal heat treatments, are highly controversial.