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A sacral stress fracture is a small break in the sacrum. The sacrum is a large triangular bone at base of the spine. The sacrum connects to the pelvis.
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Sacral stress fractures can be caused by repetitive stress or weakened bones.
Sacral stress fractures are most common in young athletes and older women with osteoporosis. Other factors that may increase the chance of a sacral stress fracture include:
The most common symptom of a sacral stress fracture is low back pain. It is important to report any unexplained lower back pain. Prompt treatment can prevent the injury from causing further problems.
Other symptoms may include:
You will be asked about your symptoms and medical history. A physical exam will be done. You may be referred to a spine specialist or a surgeon who specializes in bone problems.
Imaging tests evaluate your bones and other structures. These may include:
In general, treatment depends on the cause and severity.
Treatment options for a sacral stress fracture include:
Extra support may be needed to protect, support, and keep the 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.
Prescription and over-the-counter medications may be advised to reduce inflammation and pain.
People with osteoporosis may be advised to take medications that will increase bone density and reduce the risk of another fracture.
Fractures caused by physical stress need rest, but complete rest is rarely required. Ice may be recommended to help with discomfort and swelling. Gentle massage and heat may also be used to relieve pain.
Physical therapy or rehabilitation can help to strengthen the area.
There are some treatments that are not invasive that may help reduce healing time by stimulating bone growth. These treatments include:
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.
To help reduce your chance of a sacral stress fracture, take these steps:
To help reduce falling hazards at work and home, take these steps:
The American Orthopaedic Society for Sports Medicine
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
The University of British Columbia Department of Orthopaedics
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_backpain.htm. Accessed September 1, 2017.
Micheli LJ, Curtis C. Stress Fractures in the Spine and Sacrum. Clinics in Sports Medicine. Jan 2006;25(1).
Spondylolysis and spondylolisthesis. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00053. Updated September 2016. Accessed September 1, 2017.
Stress fractures. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00112. Updated October 2007. Accessed September 1, 2017.
Zaman FM. Sacral stress fractures. Curr Sports Med Rep. 2006;5(1):37-43.
Last reviewed September 2018 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM Last Updated: 9/30/2013