Definition

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.

Sacrum
Sacrum

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Causes

This problem can be caused by repetitive stress or weakened bones.

Risk Factors

This problem is more common in young athletes and older women with osteoporosis. Other things that may raise the risk are:

Symptoms

The most common problem is low back pain. Other problems may be:

  • Pain in hip or pelvis
  • Pain in buttocks or groin
  • Lower back tenderness
  • Swelling at lower back
  • Pain during exercise

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done. You may need to see a doctor who treats spines or one who treats bone problems.

Images may be taken. This can be done with:

Treatment

It will take several weeks for most people to heal. The goals of treatment are to manage pain and support the bone as it heals. This may include:

  • Medicine to ease pain and swelling
  • A corset or brace to support the bone as it heals
  • A cane or other device to take weight off of the lower back
  • Exercises to help with strength and range of motion

Non-Surgical Procedures

These treatments may be done to reduce healing time by stimulating bone growth:

  • 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 to stimulate growth factors to increase bone cell formation
  • Vertebroplasty —Small amounts of bone cement are injected into fracture lines. This is not done often.

Surgery

Some people may need surgery when other methods do not help. Bones are reconnected and held in place with screws or a plate.

Prevention

This problem cannot always be prevented. Starting a new sport slowly may help lower the risk of injury. Healthy bones and muscles may also help. This may be done through diet and exercise.

RESOURCES:

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

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

CANADIAN RESOURCES:

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

The University of British Columbia Department of Orthopaedics
http://orthopaedics.med.ubc.ca

REFERENCES:

American College of Obstetrics and Gynecology (ACOG) Committee on Adolescent Health Care. Committee Opinion No.702: Female Athlete Triad. Obstet Gynecol. 2017 Jun;129(6):e160-167.

Female athlete triad. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/female-athlete-triad. Updated November 7, 2019. Accessed December 6, 2019.

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. Updated August 13, 2019. Accessed December 6, 2019.

Stress fractures. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00112. Updated October 2007. Accessed December 6, 2019.

Last reviewed September 2019 by EBSCO Medical Review Board Laura Lei-Rivera, PT, DPT, GCS  Last Updated: 12/6/2019