Answer:
Dear
Matthew,
There
is no right answer
L5 stress
fractures may heal within twelve weeks as long as it is completely
rested.
It really
all depends on the size of the fracture.
In most
cases, complete rest is the treatment of choice. This would usually
be for a period of 6 weeks, to allow the bone to heal.
A Back
Brace can be helpful to provide support and partial immobilisation.
It also acts as a reminder to young people that they shouldn't do
too much activity.
A stress
fracture is one type of incomplete fracture in bones.
If a
stress fracture occurs in a weight-bearing bone, healing will be delayed
or prevented by continuing to put weight on that limb.
Rest
is the only option for complete healing of a stress fracture. The
amount of recovery time varies greatly depending upon the location,
severity, the strength of the body's healing response and an individual's
nutritional intake.
Sacral
stress fractures heal much slower because it is so difficult to immobilize
the affected area.
The amount
of recovery time will depend on how well your body heals.
On rare
occasions, spondylolysis that is not healing or may have neurological
components can require surgery to provide internal fixation and stability
to the area, and if necessary to reduce pressure on the nerves.
In general,
stress fractures of the pars interarticularis have been reported to
be caused by sports requiring repetitive loading and stress, shear
forces, repetitive flexion, rotation and hyperextension , repetitive
load-bearing hyperextension, torsion against resistance , and repeated
loading in hyperflexion and hyperextension of the spine.
Therefore,
it would appear that sports requiring repetitive loading, shearing
forces, and repetitive hyperflexion/hyperextension of the spine result
in abnormal amounts of stress to the pars interarticularis, and, ultimately,
stress fracture to the pars.
At this
time, there does not appear to be a large, controlled trial
related to the management of spondylolysis.
Standaert
et al. , (Standaert CJ, Herring SA, Halpren B, and King O. Spondylolysis.Phys
Med Rehab Clin North Am 2000;11(2):785-803) , reported the following
three criteria for treatment objectives for patients with symptomatic
spondylolysis:
1. Obtain
healing of the fracture when possible.
2. Provide pain relief.
3. Optimize physical function and, were applicable, athletic performance,
ideally with restoration of normal function.
One study
of adolescent athletes found that 37% (average age 15.5
years) showed signs of union at the pars defects after
treatment consisting of bracing for 2-6 months.
