Sacral Stress Fracture
Condition
(Sacral Stress)
Definition
A sacral stress fracture is a small break in the sacrum. This is a large triangular bone at base of the spine that connects to the pelvis.
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A sacral stress fracture can be caused by repetitive stress or weakened bones.
Risk Factors
A sacral stress fracture is more common in young athletes and older women with osteoporosis. Other things that may raise the risk are:
- Having problems that weaken the bones, such as osteoporosis
- Playing some sports, such as gymnastics or football
- Long distance running
- Weight bearing activities, such as weight lifting or military training
- Radiation therapy
- A history of Paget disease, hyperparathyroidism, osteopenia, or rheumatoid arthritis
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
The doctor will ask about symptoms and past health. A physical exam will be done.
Pictures may be taken. This can be done with:
Treatment
It will take several weeks for most people to heal. The goal of treatment is to help the bones heal properly to prevent long term problems. This may include:
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.
American Orthopaedic Society for Sports Medicine
Ortho Info—American Academy of Orthopaedic Surgeons
CANADIAN RESOURCES:
Canadian Orthopaedic Association
University of British Columbia Department of Orthopaedics
American Orthopaedic Society for Sports Medicine
Ortho Info—American Academy of Orthopaedic Surgeons
CANADIAN RESOURCES:
Canadian Orthopaedic Association
University of British Columbia Department of Orthopaedics
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.
- Low back pain fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/health-information/patient-caregiver-education/fact-sheets/low-back-pain-fact-sheet.
- Nose-Ogura S, Yoshino O, et al. Risk factors of stress fractures due to the female athlete triad: Differences in teens and twenties. Scand J Med Sci Sports. 2019; 29: 1501– 1510.
- Stress fractures. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/stress-fractures.
Contributors
- Laura Lei-Rivera, PT, DPT
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