Viewing 4 posts - 1 through 4 (of 4 total)
  • Author
    Posts
  • sm1990
    Member
    Post count: 2

    I have ignored a back fracture now for 5 years. Just got a new x-ray of back shows a stress fracture on l5-s1.
    But recently the pain is worse moving to upper body and no longer a throbbing pain.
    I was advised to stop all physical activity only walking and biking (6-8 weeks). It is not like I have been working out for the last month, just light physical exercise. I am about 1 week into “No activity” period before physical therapy.
    injury happened when I was 15 yrs old.

    Help?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8436

    From the interpretation of your e-mail, you were initially diagnosed with the pars fractures when you were 15 years old and you are now 20 years of age. You don’t mention if you have a slip of L5 on S1 (isthmic spondylolysthesis) or fractures without slip (isthmic spondylolysis).

    Treatment is now a somewhat controversial area for this disorder as we have developed very good ways to repair the fractured pars. However, repair surgery is not recommended if the disc has become degenerative or there is a substantial slip of the vertebra. In addition, repair does not absolutely guarantee full pain relief.

    Let us assume that you have degenerative changes as many individuals do with long standing pars fractures. What normally happens to cause pain is that after the fracture is initially discovered (when you were 15), the fractures remain but the pain disappears. After an incident such as lifting or twisting, the pars pannus (see web site for this) tears or the disc itself tears.

    The treatment, in my opinion is first to reduce the stress on the vertebral segments. Collagen fibers (that make up the torn pars pannus) take about 3 weeks to heal and 3 more weeks to develop tensile strength. Rest is good for a short while. Using a soft corset is also helpful. Isometric strengthening exercises for the core muscles is helpful initially. Eventually, the therapist will have to introduce loading and rotational exercises and hopefully, by 8-12 weeks, the repair has occurred and the pain has receded. I don’t mean that the fracture heals- that won’t happen, but the pars pannus can heal. Some individuals heal somewhat faster and some might continue with some discomfort.

    Hope this helps.

    Dr. Corenman

    sm1990
    Member
    Post count: 2

    Thanks for the response doctor.
    I had an x-ray taken when I was 15 but my physician didn’t note anything wrong with it. So in high school I went through normal PE class and other classes with this pain. In college, I have worked out some days but with minimal progress in overall fitness goals. Although somehow I lost 40 lbs since entering college, I thought that would fix the back problem.

    I found out about this pars interarticularis just last week. I guess me ignoring the problem has created a complication at this point it is only spondylosis not the more serious spondylolisthesis you mentioned. According to my doctor the alignment of the discs is okay.

    My situation now is sometimes during the day with or without activity the pain comes back. I might just be sitting on my computer chair and the pain gets so bad that I don’t feel like going to class for a couple hours eventually it goes away and I attend evening class.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8436

    Based upon what you indicate, you might be a candidate for an eipdural injection/ pars block (see web site). This injection may be the quickest way to reduce your symptoms.

    Alignment of the discs indicates a spondylolysis but does not indicate disc health.

    Dr. Corenman

Viewing 4 posts - 1 through 4 (of 4 total)
  • You must be logged in to reply to this topic.