Chronic lower back pain in athletes is one of the most challenging clinical problems to the sports physician. The first aim of the clinical assessment is to make an accurate anatomical/pathological diagnosis. A second and often-neglected aim is to make an accurate functional diagnosis of the low back pain in the athlete. The first step in the diagnostic work-up is to take a comprehensive clinical history. In most instances, this will provide clues to the anatomical/pathological diagnosis. Specific features in the history that provide a clue to the diagnosis are discussed. The second step is a careful systematic physical examination of the athlete. Special tests for specific conditions, which assist the sports physician in making the anatomical/pathological diagnosis, are described. Finally, detailed descriptions of some of the special clinical tests that can assist the sports physician in making a functional diagnosis are described.
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