Most cases of a lower back stress fracture don’t present symptoms, but it can sometimes produce intense pain. Here’s what you might expect in the short, medium, and long term phases of pain management.
Following a diagnosis, you will likely be advised to rest and to try to keep the pain and swelling down as much as possible. Typically several weeks are needed for sufficient healing to take place.
- Rest and protection. Take it easy and lie in bed or on a recliner. Stay away from activities that put stress on your lower back. This means avoiding high-impact exercise (for example, running and jumping), contact sports, and moving heavy furniture around until the doctor permits you to do so again.
- Ice/heat therapy. Apply an ice pack to your lower back to reduce inflammation. After a day or so, switch to an electric heating pad to encourage blood flow and healing. Apply ice/heat for less than 20 minutes at a time, and use a barrier to protect your skin. Let the skin rest and recover at least 2 hours between applications.
- Pain medications. A doctor may prescribe pain medications or advise you to use nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil, Motrin, and Aleve, as needed. These drugs may help to keep the swelling down and provide relief.
Bracing is another possible option that helps to immobilize the spine for a brief period of time, though it’s used less often.
A person with a lower back stress fracture is typically advised to participate in a rehabilitation or physical therapy program. The goal is to encourage bone healing, provide pain relief, and restore function.
- Visit a physical therapist or athletic trainer. A health professional such as a physical therapist or athletic trainer can safely guide you through stretches and exercises, personally tailoring a regimen to fit your specific situation.
- Stretch. A health care professional can help you to target tight leg and back muscles, which increases your range of motion. Loosen the upper and lower back extensor muscles, hamstrings, and glutes. Focus on neutral spine alignment.
- Gentle core-strengthening exercises. Eventually, gentle exercises that strengthen abdominals, lower back muscles, and hips may be introduced.
Rehabilitation programs look different for each individual patient. Your pain tolerance should guide you as you build core strength and increase in aerobic fitness over time.
With proper rest and rehabilitation, most people with a lower back stress fracture can return to full activity within a few months. Sometimes the timeline is longer.
If rest and rehabilitation don’t alleviate pain and restore function, surgery is a possible option to consider—though this is rare.