Spondylolysis is a stress or fatigue fracture of an area of the spine called the pars interarticularis. Typically, spondylolysis is caused by repetitive hyperextension (arching) and rotation of the back; muscle tightness & strength imbalances of the back and core muscles may also contribute. This repetitive or excessive force causes injury that exceeds the bone’s ability to heal. Rarely, it can occur due to an acute fracture with severe trauma from a sudden blow. This injury is commonly seen in adolescent athletes complaining of low back pain.
Common signs and symptoms of spondylolysis include:
The following can decrease the risk of obtaining spondylolysis:
Risk factors associated with spondylolysis include:
The following are potential complications associated with spondylolysis:
Initial treatment consists of rest from activities that cause the pain (no hyperextension). Non-steroidal anti-inflammatory medications (such as ibuprofen) or other minor pain relievers (such as acetaminophen) are sometimes recommended for pain. Application of ice may also be used to relieve pain. A back brace may be recommended to prevent hyperextension. As pain subsides, a referral to a physical therapist or athletic trainer may be recommended for evaluation and further treatment. Rehabilitation exercises focus on improving strength and flexibility and learning proper back mechanics. Symptoms typically improve within 6-12 weeks and return to sport is often possible within 3-6 months. Surgery is rarely necessary and is reserved for those athletes who have persistent pain despite 6 to 12 months of appropriate conservative treatment.
Consult your primary care physician for more serious injuries that do not respond to basic first aid. As an added resource, the staff at Nationwide Children’s Hospital Sports Medicine is available to diagnose and treat sports-related injuries for youth or adolescent athletes. Services are now available in five locations. To make an appointment, call (614) 355-6000 or request an appointment online.