Lumbar Stress Fracture (Spondylolysis)

A stress fracture can develop of the pars interarticularis – an area on the vertebrae near the facet joints. This stress fracture is referred to as a spondylosis.

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If the stress fracture progresses it can lead to a spondylolisthesis – which is where one of the vertebrae becomes unstable and subluxes forward.

Background

A Spondylolysis is frequently seen in adolescents who participate in sports involving repetitive and excessive extension or rotation of the lower back (e.g. gymnasts, cricket bowlers, high jump, ballet). A Spondylolysis or spondyloslisthesis can also be seen later in life, due to the wear and tear process of aging.

Symptoms

  • Lower back pain on one side – usually at night, or with extension based activities (walking, running, jump/landing). Sometimes buttock/leg pain may be present.
  • Morning stiffness and ache.
  • Muscle tightness or guarding around the area of pain.
  • Overtime, the individual may develop a stooped posture to adapt in order to reduce pain.

Care

  • An MRI/CT/bone scan can confirm a stress fracture earlier on. An X-ray will usually only show at later stages.
  • Advice – usually involves a period of rest from sport, to allow the fracture to heal. Your Physio may also discuss what movements/activities they want you to avoid.
  • Release tight muscles with massage or dry needling – especially in the lower back, glutes and hamstrings.
  • Clinical Pilates/Exercise Rehab – core control, teach controlled extension, glute strength, muscle flexibility.

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