Munson Health
 
Sacral Stress Fracture

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by Kellicker PG

(Sacral Stress)

 

Risk Factors

Sacral stress fractures are most common in young athletes and older women with osteoporosis. Other factors that may increase your chance of a sacral stress fracture include:
  • Certain diseases or conditions that result in bone or mineral loss, such as abnormal or absent menstrual cycles, or post-menopause
  • Adolescents with incomplete bone growth
  • Playing certain sports that may result in collisions or falls, such as gymnastics, football, or other high-impact sports
  • Long-distance running
  • Weight-bearing activities, such as weight lifting or military training
  • Radiation therapy
  • History of Paget’s disease, hyperparathyroidism, osteopenia, or rheumatoid arthritis
 

Treatment

In general, treatment depends on the cause and severity.
Treatment options for a sacral stress fracture include:

Intial Care

Extra support may be needed to protect, support, and keep your back in place while it heals. Supportive steps may include a corset or brace.
Fractures due to osteoporosis are treated with partial weight bearing. A cane or other device will be used for this.

Medications

Your doctor may prescribe:
  • Over-the-counter medications to reduce inflammation and pain
  • Prescription pain relievers
If you have osteoporosis, your doctor will recommend different medications that will increase bone density and reduce your risk of another fracture.
Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.

Rest and Recovery

As you recover, you may be referred to physical therapy or rehabilitation for strengthening exercises. Do not return to activities or sports until your doctor gives you permission to do so.

Non-Surgical Procedures

There are some treatments that are not invasive that may help reduce healing time by stimulating bone growth. These treatments include:
  • Electrical stimulation—Electrical and magnetic impulses stimulate enzymes to increase bone cell formation.
  • Extracorporeal shock wave therapy—High-energy shock waves are passed through body tissues. The waves stimulate growth factors to increase bone cell formation.
  • Vertebroplasty—Small amounts of bone cement are injected into fracture lines guided by CT scan. It is not known what the long-term side effects of the cement are. Because of this, vertebroplasty is used on a limited basis.

Surgery

If other treatment does not work, surgery may be required. Surgery is generally indicated if the break is unstable, there are nerve problems, or the sacrum is not properly aligned. Bones are reconnected and held in place with screws or a plate.
 

RESOURCES

American Academy of Orthopaedic Surgeons
http://www.orthoinfo.org

American Orthopaedic Society for Sports Medicine
http://www.aossm.org

 

CANADIAN RESOURCES

Canadian Orthopaedic Association
http://www.coa-aco.org

Canadian Orthopaedic Foundation
http://www.canorth.org

 

References


Hosey RG, et al. Evaluation and Management of Stress Fractures of the Pelvis and Sacrum. Orthopedics. 2008; 31:383.


Lin JT, Lane JM. Sacral stress fractures. Journal of Women’s Health. 2003;12(9):879-888.


Longhino V, Bonora C. The management of sacral stress fractures: current concepts. Clin Cases Miner Bone Metab. 2011;8(3):19-23.


Low back pain fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/backpain/detail%5Fbackpain.htm. Updated May 1, 2013. Accessed September 23, 2013.


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 Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00053. Updated October 2007. Accessed September 23, 2013.


Stress fractures. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00112. Updated October 2007. Accessed September 23, 2013.


Zaman FM. Sacral stress fractures. Curr Sports Med Rep. 2006;5(1):37-43.

 

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