7.6.6: Sports Activities and Lower Back Pain in Adolescence

Lower back pain is a serious condition that can become a chronic lifetime issue. Research has shown that lower back pain is as prevalent in childhood and adolescence as it is in adulthood (Balagué et al. 1988; Balagué et al. 1995; Burton et al. 1996; Hestbaek et al. 2006; Jones et al. 2004; Kazemi 2025; Leboeuf-Yde and Kyvik 1998; Li et al. 2024; Salminen et al. 1992; Taimela et al. 1997). Throughout the years many potential sources of this problem have been identified, including lifestyle choices, playing video games, the weight of school bags, and physical health factors (Sato et al. 2011). One study considered survey data collected from 26,766 students in Niigata City, Japan, to determine whether participation in sports activities may increase the likelihood that lower back pain is developed in adolescents (Sato et al. 2011).

The study included all schoolchildren, including all elementary school students from the fourth to sixth grade and all junior high students from the first to third year, in Niigata City, located on the west coast of Japan. The children ranged in age from 9 to 15 years old. An anonymous questionnaire was distributed to each school. The data were collected from October to November in 2005. The survey collected basic demographic and health-related information along with any experience of lower back pain in the present and the past. Additionally, the details of sports activities other than school physical education classes, musical activities, and social activities were reported in the questionnaire. The amount of time spent participating in sports activities was also reported.

The responses were divided between those who did not participate in sports activities except for physical education in school and those who participated in sports activities. The prevalence of lower back pain was divided into three levels: level 1, no limitation in any activity; level 2, necessary to refrain from participating in sports and physical activities; and level 3, severe lower back pain, where a student needed to refrain from participating in sports and physical activities and was absent from school. The amount of time students spent participating in sports activities was divided into three time ranges: less than 6 hours per week, between 6 and 12 hours per week, and more than 12 hours per week.

The researchers in the study compared the odds of developing severe lower back pain for students who did not participate in sports against those who did and provided a detailed analysis for 21 different sporting activities. Statistical methods were used to remove the potential confounding effects of age, gender, and body mass index. When comparing all the students who participated in the sports against those who did not, the odds ratio for severe lower back pain was 1.57, indicating that the sports group had a slightly higher prevalence of severe lower back pain. The results varied by the type of sport that the student reported playing. For example, the odds ratio for students who played table tennis was 1.05, indicating that the odds of severe lower back pain were almost the same as students who did not participate in sports. On the other hand, the odds ratio for rugby was 2.58, indicating that the odds of having lower back pain for rugby players was more than twice that of students who did not participate in sports. One sport, sumo wrestling, had an odds ratio of 0.85, which indicates that students who participated in this sport had lower odds of severe lower back pain than students who did not participate in sports. Sumo wrestling was the only sport that had such a result.