Treatment of Fatigue Fracture of Vertebra
Clinical Overview
Fatigue fracture of the vertebra is a stress-related osseous injury arising from repetitive mechanical loading. Management focuses on offloading the injured segment, controlling pain, and guiding a safe, structured return to activity.
Treatment Approach
The evidence-based approach is nonoperative. Management centres on discontinuation of the precipitating activity combined with a progressive structured physical therapy program. Pain control measures may be used early to allow participation in rehabilitation. External bracing is considered under specific circumstances.Full regimen details, sequencing, and individualized criteria are available in the complete protocol.
Clinical Goals
The primary short-term targets are resolution of pain and normalisation of lumbar range of motion, benchmarked over the initial weeks following injury, enabling progressive return to usual activity.
References
DOI: 10.1155/2020/9235958
- All patients were treated nonoperatively with prescription for a thoracolumbar orthosis and discontinuation of sporting activity for three months followed by a structured PT program.
- However, specific to the diagnosis of spondylolysis, there is good evidence for conservative management, including the restriction of activity/sport combined with PT and implementation of external bracing only if symptoms persist.
- At our facility, we work closely with referring physicians who will utilize NSAIDs and, in some cases, spinal injections to reduce pain initially after diagnosis to allow for improved tolerance of therapeutic activity.
- In the short-term following injury, typically defined as six weeks, the majority of patients with spondylolysis will symptomatically improve, and the majority of athletes return to usual sporting activity.
- Resolution of pain and normalized ROM are the initial goals of treatment and are utilized as a benchmark throughout the rehabilitation process to allow for progression of activity.
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