Lumbar Stress Fracture

What is a lumbar stress fracture?

A stressy is when you get repetitive load through a bone and it says ‘OW!’. A key thing to know is that it’s more like a continuum rather than a quick ‘break’. This is a rough summary: bony bruising < stress response < complete pars fracture (where the bone is fully fractured). Another big word to understand is ‘sponylolithesis’ which is where the stress fracture has happened on both side and the vertebrae has moved a wee bit relative to the one above it. Sounds worse than it is! (Lots of people have spodylolithesis and no pain). So when someone says ‘stress fracture’ it’s worth diving into the detail and understanding exactly what they mean. Mostly these happen in young athletic populations and some sports are more likely to see them (dance, rowing, soccer, cricket).

Why does a lumbar stress fracture happen?

Overuse. There are some genetic factors but if a young athlete is loading their lower back repetitively under high load – they are more likely to get a lumbar stress fracture. Sports with lots of extension (backwards bending) are involved increase the likelihood. Fast bowlers in cricket, rowers and all those dancers with fabulous arabesques have more risk simply because the load on the lumbar spine is high.

What can you do about a lumbar stress fracture?
Lumbar Physiotherapy in Newcastle.

1. Image first. An MRI is the best type of investigation to get as it is the ‘gold standard’ for diagnosing stressys. A bone scan is also useful but because it involves radiation, an MRI is preferable. So if there’s any Q about diagnosis from the physio – get some pictures first.
2. Rest. Normally you will need a minimum of 6 wks off your sport/activity to allow the bone to heal. Sometimes it needs longer (up to 12 wks) depending on the person and the sport.
3. Strength. After 5-6 wks you can start to introduce gentle strength work. Some low impact cycling, hydrotherapy or pilates style strength can be helpful. Make sure its outside of pain! Progress strength under the close supervision of your physio.

How long will a lumbar stress fracture take?

Minimum 6-8 wks but sometimes up to 12-14 wks. Depends on how bad, how long, type of sport and type of person.