Thornton Jane S, Caneiro J P, Hartvigsen Jan, Ardern Clare L, Vinther Anders, Wilkie Kellie, Trease Larissa, Ackerman Kathryn E, Dane Kathryn, McDonnell Sarah-Jane, Mockler David, Gissane Conor, Wilson Fiona
Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Department of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Br J Sports Med. 2021 Jun;55(12):656-662. doi: 10.1136/bjsports-2020-102723. Epub 2020 Dec 21.
To summarise the evidence for non-pharmacological management of low back pain (LBP) in athletes, a common problem in sport that can negatively impact performance and contribute to early retirement.
Five databases (EMBASE, Medline, CINAHL, Web of Science, Scopus) were searched from inception to September 2020. The main outcomes of interest were pain, disability and return to sport (RTS).
Among 1629 references, 14 randomised controlled trials (RCTs) involving 541 athletes were included. The trials had biases across multiple domains including performance, attrition and reporting. Treatments included exercise, biomechanical modifications and manual therapy. There were no trials evaluating the efficacy of surgery or injections. Exercise was the most frequently investigated treatment; no RTS data were reported for any exercise intervention. There was a reduction in pain and disability reported after all treatments.
While several treatments for LBP in athletes improved pain and function, it was unclear what the most effective treatments were, and for whom. Exercise approaches generally reduced pain and improved function in athletes with LBP, but the effect on RTS is unknown. No conclusions regarding the value of manual therapy (massage, spinal manipulation) or biomechanical modifications alone could be drawn because of insufficient evidence. High-quality RCTs are urgently needed to determine the effect of commonly used interventions in treating LBP in athletes.
总结运动员下背痛（LBP）非药物治疗的证据，下背痛在体育运动中是一个常见问题，会对运动表现产生负面影响并导致运动员过早退役。
检索了5个数据库（EMBASE、Medline、CINAHL、Web of Science、Scopus），检索时间从建库至2020年9月。主要关注的结果是疼痛、功能障碍和重返运动（RTS）。
在1629篇参考文献中，纳入了14项涉及541名运动员的随机对照试验（RCT）。这些试验在多个领域存在偏倚，包括表现、损耗和报告。治疗方法包括运动、生物力学调整和手法治疗。没有试验评估手术或注射的疗效。运动是研究最频繁的治疗方法；没有任何运动干预报告RTS数据。所有治疗后疼痛和功能障碍均有减轻。
虽然运动员LBP的几种治疗方法改善了疼痛和功能，但尚不清楚最有效的治疗方法是什么，以及对哪些人有效。运动方法通常可减轻运动员LBP的疼痛并改善功能，但对RTS的影响尚不清楚。由于证据不足，无法得出关于单纯手法治疗（按摩、脊柱推拿）或生物力学调整价值的结论。迫切需要高质量的RCT来确定常用干预措施对治疗运动员LBP的效果。
