Stress fractures in the lower back

What is it?

Often referred to as pars defect and is an incomplete fracture with in rear portion of the vertebral arch.

If it occurs on both sides of the vertebrae and the vertebral body ‘slips’ forward it is called a spondylolisthesis (these are graded 1 to 4, depending on severity).

How does it happen?

It usually results from an overuse injury with activities requiring excessive extension (arching) and/or rotation (e.g. fast bowling).

The rear portion of the vertebra is placed under stress and reacts by increasing bone turn over (replacing the old with new).

If this process results in greater re-absorption than new bone formation then an area of weakness develops and a fracture can take place if the bone is continually loaded (stress fracture).

How does it feel?

The condition may cause pain in the low back (typically one sided) with the possible presence of buttock or leg pain.

The condition is aggravated by activities involving extension and rotation.

As it worsens you may experience pain with prolonged standing and with lying.

Pars defects and a spondylolisthesis can be congenital and asymptomatic.

These are typically found incidentally on x-rays for varying low back conditions.

How is the diagnosis made?

Diagnosis is made via a thorough history and physical assessment.

X-rays, bone scans and/or CT scan can be requested to confirm the diagnosis and stage of healing.


Could there be any long-term effects?

It is possible that defects may never heal, and that a spondylolisthesis may remain the same. But despite this, appropriate management can usually return to your desired level of activity.

Contact a Lifecare practitioner for more information. Click here to find your closest Lifecare clinic