Elite Cross-Country Skiers Who Report Low Back Pain Have More Disk Degeneration Than Their Nonsymptomatic Peers

To investigate the prevalence of low back pain (LBP) and disk degeneration (DD) and the relationship of DD with LBP among elite cross-country skiers.

A cross-sectional study of elite cross-country skiers.

Study participants were recruited during autumn 2022 among elite cross-country skiers and collegiate skiers who were selected to national teams' training groups.

The original study group consisted of 44 skiers (16 national team skiers and 28 sports academy skiers).

The study protocol included a 1.5T lumbar spine MRI, a clinical examination, and an interview with questions about general health and training as well as selected patient-reported outcomes. The morphology of intervertebral disks from T12/L1 to L5/S1 on sagittal T2-weighted midline images was visually assessed using the Pfirrmann classification with a grade 3 or higher considered degenerated in this age group.

Cross-sectional occurrence of DD on MRI and self-reported LBP.

Low back pain was reported by 33 (75%) skiers. Half of the skiers had at least 1 disk of ≥grade 3 in the Pfirrmann classification. At least 1 disk grade ≥3 in the Pfirrmann classification was found in 61% (20 of 33) of skiers with LBP and 18% (2 of 11) of skiers without LBP ( P = 0.034).

The most important findings in our study were the high prevalence of self-reported LBP and a statistically significant difference in the occurrence of at least 1 degenerated disk in the Pfirrmann classification between skiers who reported LBP compared with those who did not.