Short-term outcome of conservative treatment in athletes with symptomatic lumbar disc herniation

The purpose of this study was to clarify the efficacy of conservative treatment in athletes with symptomatic lumbar disc herniation, especially in terms of their ability to return to their original sporting activities.

A total of 71 consecutive athletes (53 men and 18 women), who consulted our sports medicine clinic during the 10-yr period between September 1993 and October 2003 because of severe low back pain or leg pain/numbness due to lumbar disc herniation (confirmed on magnetic resonance images), were studied. The mean age of the subjects was 21 yrs. All of them were conservatively treated by advising them to discontinue their sporting activities, with or without short-term medication. After the subjective symptoms had reduced by >80%, individual training was started to allow the athletes to return to their original sporting activities.

A total of 56 athletes (78.9%) could return to their original sporting activities at an average of 4.7 mos (range, 1-12 mos) after the start of treatment and were able to sustain the activities for > or =6 mos, the minimum duration of follow-up in this study. The outcome of the conservative treatment was not influenced by the intensity of the sporting activity. Multiple logistic regression analyses showed that the only factor influencing the ability of the athletes to return to their original sporting activities was the severity of the symptoms before the start of treatment.

The results of this study suggest that the short-term outcome of conservative treatment in athletes with symptomatic lumbar disc herniation may be satisfactory in terms of control of the symptoms and the ability of the athletes to return to their original sporting activities and that the subjective symptoms before treatment may be a key factor influencing the success of the conservative management. Randomized controlled trials, or even comparative follow-up studies, are needed to confirm our results.