London Health Sciences Centre, London, Ontario, Canada.
Sports Health. 2009 May;1(3):212-22. doi: 10.1177/1941738109334212.
Low back pain in young athletes is a common complaint and should be taken seriously. It frequently results from a structural injury that requires a high degree of suspicion to diagnose and treat appropriately.
A Medline search was conducted from 1996 to May 2008 using the search terms "low back pain in children" and "low back pain in athletes." Known texts on injuries in young athletes were also reviewed. References in retrieved articles were additionally searched for relevant articles. Sources were included if they contained information regarding diagnosis and treatment of causes of low back pain in children.
Low back pain is associated with sports involving repetitive extension, flexion, and rotation, such as gymnastics, dance, and soccer. Both acute and overuse injuries occur, although overuse injuries are more common. Young athletes who present with low back pain have a high incidence of structural injuries such as spondylolysis and other injuries to the posterior elements of the spine. Disc-related pathology is much less common. Simple muscle strains are much less likely in this population and should be a diagnosis of exclusion only.
Young athletes who present with low back pain are more likely to have structural injuries and therefore should be investigated fully. Muscle strain should be a diagnosis of exclusion. Treatment should address flexibility and muscle imbalances. Injuries can be prevented by recognizing and addressing risk factors. Return to sport should be a gradual process once the pain has resolved and the athlete has regained full strength.
青少年运动员的下腰痛是一种常见的主诉，应予以重视。它常源于结构损伤，需要高度怀疑才能做出正确诊断和治疗。
从 1996 年到 2008 年 5 月，我们使用“儿童下腰痛”和“运动员下腰痛”这两个检索词，在 Medline 上进行了检索。还查阅了关于青少年运动员损伤的已知文献。对检索到的文章中的参考文献进行了额外的搜索，以寻找相关文章。如果文章中包含有关儿童下腰痛病因的诊断和治疗信息，则将其作为资料来源。
下腰痛与涉及重复伸展、弯曲和旋转的运动有关，如体操、舞蹈和足球。既有急性损伤也有过度使用损伤，但过度使用损伤更为常见。出现下腰痛的年轻运动员结构损伤的发生率很高，如峡部裂和脊柱后部其他损伤。椎间盘相关病变则少见得多。在该人群中，单纯的肌肉拉伤非常少见，仅应作为排除性诊断。
出现下腰痛的年轻运动员更有可能存在结构损伤，因此应进行全面检查。肌肉拉伤应作为排除性诊断。治疗应针对柔韧性和肌肉失衡问题。通过识别和处理危险因素，可以预防损伤。一旦疼痛缓解且运动员恢复了全部力量，就应逐步恢复运动。
