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Answer to your Health Question

Question :

How long does a L5 stress fracture take to heal?

Also why and how does it not heal?



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.

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