{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T05:39:37Z","timestamp":1766986777587,"version":"3.48.0"},"reference-count":39,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Scandinavian Med Sci Sports"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Intensive training in competitive sports during childhood and adolescence may increase the risk of low back pain (LBP). While disc degeneration (DD) is a known contributor to LBP, its occurrence among elite cross\u2010country skiers has not been previously assessed using magnetic resonance imaging (MRI). This study aimed to compare the prevalence of LBP and DD in elite cross\u2010country skiers and age\u2010matched non\u2010athlete controls. Forty\u2010four elite skiers and 71 controls underwent a structured interview assessing LBP without specific trauma, a clinical examination, and lumbar spine MRI. Skiers also completed patient\u2010reported outcome measures (PROMs). Disc morphology was evaluated from MRI using the Pfirrmann classification (grades 1\u20135). A Pfirrmann Summary Score (PSS) was calculated by summing the grades of the individual discs. Analyses were adjusted for age and sex. LBP was reported by 75% of skiers and 54% of controls (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.028). DD prevalence, defined as at least one disc graded  3, did not differ significantly between the groups (50% versus 42%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.78). In both groups, individuals with LBP had significantly higher PSS than their asymptomatic peers. Elite skiers reported more LBP than controls, despite similar DD prevalence. These findings suggest that while intensive training may not increase DD risk, it may contribute to a higher burden of LBP. The association between PSS and LBP was consistent across groups, indicating that structural disc changes may play a role regardless of athletic status.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                    identifier: NCT05641857\n                  <\/jats:p>","DOI":"10.1111\/sms.70187","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T14:46:19Z","timestamp":1766155579000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of Low Back Pain and Disc Degeneration in Elite Cross\u2010Country Skiers: A Comparative Study With Non\u2010Athlete Controls"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8501-6735","authenticated-orcid":false,"given":"Anni","family":"Aavikko","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology Wellbeing Services County of P\u00e4ij\u00e4t\u2010H\u00e4me  Lahti Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janne","family":"Pesonen","sequence":"additional","affiliation":[{"name":"Kuopio University Hospital Department of Rehabilitation  Kuopio Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leena","family":"Ristolainen","sequence":"additional","affiliation":[{"name":"Orton, Research Institute Orton  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9820-1390","authenticated-orcid":false,"given":"Niko","family":"Murto","sequence":"additional","affiliation":[{"name":"Department of Radiology Helsinki University and Helsinki University Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannu","family":"Kautiainen","sequence":"additional","affiliation":[{"name":"Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland and Folkh\u00e4lsan Research Center  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teija","family":"Lund","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Helsinki University and Helsinki University Hospital  Helsinki 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