Sacral Insufficiency Fractures

Sacral insufficiency fractures are the fractures that occur when the sacrum, which forms the base of the spine and the center of the pelvis, is so weakened that it can no longer support a person's weight. Elderly women with osteoporosis are most likely to have sacral insufficiency fractures, though they can also occur in women who are pregnant or breastfeeding, as a result of temporary osteoporosis.

Other risk factors that can weaken sacral bone include radiation to the pelvis, use of steroids, rheumatoid arthritis, hyperparathyroidism, anorexia nervosa, liver transplantation, osteopenia, Paget's disease, hip joint replacement and lumbosacral fusion.

Symptoms of Sacral Insufficiency Fractures

  • Severe pain in the buttocks, back, hip, groin and/or pelvis
  • Halting, painful walking
  • Tenderness in the back or pelvic area
  • Limited range of motion in the low back
  • In rare cases, disturbed bowel or bladder function with decreased leg strength and sensation

Treatment for sacral insufficiency fractures is usually non-surgical and consists of rest, pain medications and walking with a walker or crutches. Most people are pain-free in 6 to 12 months.

Sacroplasty is a procedure in which a “cement” is injected into the bone to stabilize the bone. Occasionally, surgery may be required.

Treatment of Sacral Insufficiency Fractures

Your doctor may prescribe water exercise and wearing a corset. To help fractures heal, you'll take calcium with vitamin D or other medications that strengthen bones.

Some doctors believe that you should not take nonsteroidal anti-inflammatories (NSAIDs) such as naproxen (Aleve) or ibuprofen (Motrin, Advil) for at least 3 to 4 weeks after a new fracture; they may slow fracture healing.

Physical therapy, heat, massage and using a TENS (Transcutaneous Electrical Nerve Stimulation) unit may help alleviate pain.

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