Many people with spondylolysis are asymptomatic and do not realize they have the condition. It can lead to chronic back pain and loss of flexibility if left untreated. Although adolescents who engage in sports, such as gymnastics, football and weightlifting, are most at risk of this condition, it can also occur in people of all ages without injury or sports participation.

What Is Spondylolysis?

The spine is the body's central support structure that keeps us upright. It comprises a chain of 24 small rectangular-shaped bones, called vertebrae, stacked on top of one another. The vertebrae create a canal that protects the spinal cord and nerve roots. It also makes the natural curves of the back.

Spondylolysis, also called pars fracture or pars defect, is a crack or break in the pars or pars interarticularis of the lumbar vertebrae. The pars interarticularis is a small, thin portion of the vertebra that connects the upper and lower facet joints.

Facet joints are small joints that provide stability and help control the movement of the spine. They work like hinges and run in pairs down the length of the spine on each side.

Spondylolysis may be congenital or acquired. Some children are born with spondylolysis, while adolescents involved in higher-risk sports develop this condition through repetitive stress or injuries to the lower back. These sports include:

  • Gymnastics
  • Dance
  • Football (particularly linemen)
  • Rugby
  • Wrestling
  • Martial arts
  • Soccer
  • Basketball
  • Cheerleading
  • Pitching
  • Golf
  • Tennis
  • Volleyball
  • Weightlifting
  • Butterfly and breaststroke swimming

What Are the Symptoms of Spondylolysis?

People with spondylolysis usually do not know they have it until they experience lower back pain, which generally worsens with exercise or other physical activity, especially those that can strain the lower back or involve a lot of leaning back. When symptoms do occur, the pain may:

  • Range from mild to severe in intensity.
  • Feel similar to a muscle strain.
  • Radiate to the buttocks and back of the thighs.
  • Worsen with activity and improve with rest.

Often, patients with spondylolysis will also have some degree of spondylolisthesis. In spondylolisthesis, the stress fracture weakens the bones so much that they cannot maintain their proper position in the spine, causing the vertebrae to slip forward directly to the bone below it. The instability in the spine can cause pain and may also promote the formation of bone spurs or arthritis.

What Are the Causes of Spondylolysis?

Young people are more susceptible to spondylolysis because their bones are still growing. In addition, overuse or overstretching of the lumbar spine can weaken the pars interarticularis, leading to fracture and/or slippage of a vertebra over time.

Genetics can also play a part in developing stress weakness at the location of a spondylolysis. Doctors believe some people are born with thinner vertebral bone than normal, making them more vulnerable to fractures.

How To Diagnose Spondylolysis?

If you have symptoms of spondylolysis, your doctor may ask about your medical history and perform a physical examination of the different areas of your back. You may need to bend backward to hyperextend your spine to check if these movements cause back pain. If you do feel pain, there may be a fracture in your pars interarticularis.

However, other conditions can cause back pain, including a pinched nerve or herniated disc. Your doctor may order the following tests to help rule those out or confirm a diagnosis of spondylolysis:

  • Back X-rays – detect fractures in the spine.
  • Computed tomography (CT) scans – look for more minor fractures if X-rays are not clear.
  • Bone scans – show increased bone activity at the site of the spondylolysis often used in children and young adults.
  • Lumbar magnetic resonance imaging (MRI) scans – evaluate leg pain and identify possible areas of stenosis, a condition characterized by the narrowing of the space around the spinal nerves.

What Are the Treatments of Spondylolysis?

Spondylolysis treatment aims to reduce pain, allow a recent pars fracture to heal, decrease spasms and restore spinal flexibility. Most spondylolysis improves with noninvasive treatments when caught early.

If your doctor suspects you have spondylolysis, you may be asked to follow a treatment plan that may include:

  • Anti-inflammatory drugs to help ease pain and swelling.
  • Physical therapy.
  • Bracing.
  • Trunal core muscle strengthening (pilates or yoga) that does not strain the lower back.
  • Rest, which includes taking a break from sports and other strenuous activities.

Most patients with mild spondylolysis feel better three months after undergoing nonsurgical treatments. However, surgery can treat the symptoms if the condition leads to chronic back pain and loss of flexibility.

Surgical procedures to help treat chronic pain, spasm or slippage despite conservative treatments include:

  • Spinal fusion – an option if noninvasive treatments fail to treat symptoms due to severe or high-grade slippage, progressively worsening slippage and chronic back pain that does not go away even after nonsurgical treatment. The goals of spinal fusion are to prevent further slip progression, stabilize the spine and alleviate significant back pain by fusing the affected vertebrae so that they heal into a single, solid bone.
  • Pars repair – a procedure that removes and stabilizes rigid or problematic bones to restore flexibility. Doctors recommend this procedure if there is spondylolisthesis (disc slippage) or moderate or severe disc degeneration at a vertebra level.


Following proper techniques and sports safety measures are essential after getting a spondylolysis diagnosis. Although spondylolysis is hard to prevent, young athletes and people who are vulnerable to this condition can help lower their risk by:

  • Limiting time spent on sports that involve repeated stress on the lower back.
  • Getting enough rest and recovering after physical activities.
  • Keeping core muscles strong.
  • Warming up properly before engaging in any sport or exercise.
  • Stretching regularly.
  • Using safety equipment correctly.
  • Following the rules and techniques for their sport or activity.
  • Maintaining a healthy weight.

If you have spondylolysis symptoms, consult your doctor to help you understand your condition. Please don't delay care. We're here for you, always.

We’ve Got Your Back

You don’t have to bear the burden of pain alone. Our providers are here to listen to you and provide compassionate care. Whether you’re suffering from neck pain, an injury or any other orthopedic condition affecting your spine, Nacogdoches Medical Partners is here to help. We provide spine care services from diagnosis to treatment and rehabilitation. Early treatment may help relieve your symptoms and prevent your condition from worsening. Call 888-421-9679 or click the button below to schedule an appointment.