A sacral stress fracture is a small break in the sacrum. The sacrum is a large triangular bone. It is the base of the spine and connects to the pelvis. Spondylolysis fracture specifically affects the back thinner side of the bone.
Stress fractures are caused by repeated physical stress or conditions that make the bones weaker. Sacral stress fractures are most common in young athletes and older women with osteoporosis . If you have unexplained lower back pain, talk to your doctor. Prompt treatment can prevent the injury from further problems.
Sacral stress fractures can be caused by repetitive stress or weakened bones. Factors that can contribute to this type of fracture include:
These factors increase your chance of sacral stress fractures. Tell your doctor if you have any of these risk factors:
The most common symptom of a sacral stress fracture is low back pain. If you have any of these symptoms do not assume it is due to a sacral stress fracture. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Sometimes blood tests will be taken. You may be referred to a spine specialist or a surgeon who specializes in bone problems.
Tests may include the following:
If the x-ray images are not definitive, you may have:
In general, treatment depends on the cause and severity. These fractures are often treated with rest and medications for pain. Minimally invasive procedures are sometimes used. Surgery may be needed. In this case a pin may be inserted into the bone. This will strengthen it and allow it to heal. Treatment options include the following:
Your plan will depend upon what caused the fracture. Fractures caused by physical stress need rest. Return to full activity and weight bearing is gradual. Fractures due to osteoporosis are treated with partial weight bearing. A cane or other device will be used for this. Therapy in the pool may also be advised. Your doctor may also offer physical therapy to help you strengthen your muscles.
Gentle massage , heat, and transcutaneous electrical stimulation (TENS) may also be used to relieve pain.
Depending upon your underlying condition, your doctor may prescribe:
In some cases your doctor may choose to immobilize your injury. A corset or brace can provide support and relief.
To help reduce your chance of getting sacral stress fractures, take the following steps:
American Academy of Orthopaedic Surgeons
American Orthopaedic Society for Sports Medicine
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Hosey RG, et al . Evaluation and Management of Stress Fractures of the Pelvis and Sacrum. Orthopedics . 2008; 31:383.
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Low back pain fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm . Accessed October 23, 2008.
Micheli LJ, Curtis C. Stress Fractures in the Spine and Sacrum. Clinics in Sports Medicine . Jan 2006;25(1).
Spondylolysis and spondylolisthesis. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00053 . Accessed October 23, 2008.
Stress fractures. MayoClinic website. Available at: http://www.mayoclinic.com/print/stress-fractures/DS00556/DSECTION=all&METHOD=print . Accessed October 23, 2008.
Zaman FM. Sacral stress fractures. Curr Sports Med Rep . 2006;5(1):37-43.
Last reviewed November 2008 by John C. Keel, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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