Last reviewed: September 29, 2026

It may be. A stress fracture in the lower back is one of the most common causes of lasting low back pain in young athletes who bend backward a lot.

The injury is called spondylolysis. It is a crack in a small bony bridge at the back of a vertebra in the lower spine. Repeated backward bending and twisting, as in gymnastics and dance, stresses that bridge. According to the American Academy of Pediatrics, dancers and gymnasts are especially prone to back pain from overuse.

In a review of 9 studies, about 4 in 10 athletes with low back pain had this stress fracture. In a study of 902 young athletes with the injury, gymnastics was the most common sport among those who played only one sport year-round.

X-rays are often the first test, but they may miss it. MRI appears about as accurate as a CT scan, uses no radiation and can show stress in the bone before a crack forms. No simple examination test reliably finds it.

Most young athletes get better without surgery. Treatment usually starts with a break from the sport that causes the pain. In a trial of 64 young athletes, those who started physical therapy within a week returned to sport about 38 days sooner than those who rested first. Their back pain also came back less often over the next year: 3% compared with 29%. In the same trial, most showed healing on MRI at 3 months without a rigid brace.

Bracing is debated. In a Finnish study of 57 teenagers, a rigid back brace did no better than a soft elastic support. The bone healed in 20 of 30 teenagers with the brace and 17 of 27 with the soft support. Only some of them were assigned to a treatment by chance.

In a review of 11 studies of 376 young athletes, about 92% returned to sport without surgery.

Healing of the bone still matters. In the Finnish study, 5 of 57 teenagers developed a forward slip of the vertebra, called spondylolisthesis. It was more likely when the bone had not healed. Teenagers whose bone healed also reported better quality of life two years later.

In general:

  • Back pain that does not go away, especially when bending backward, deserves a doctor’s visit.
  • See a doctor promptly for numbness, tingling or weakness in the legs, or bladder or bowel problems.
  • Ask whether physical therapy can start early.
  • A gradual return to sport is usually planned once the pain is gone.

Drafted with AI assistance from published sources, reviewed and edited by Babak Sheikh, MD.

Sources:

This is general information about what published research shows. It is not medical advice and it is not about your situation. Reading it does not create a doctor-patient relationship with me. I am a retired orthopedic surgeon and I do not see patients. Talk with your own doctor before changing anything about your care. If something feels suddenly or seriously wrong, get medical care promptly rather than waiting.

This page is provided as is. I make no guarantee that it is accurate, complete or current, and medical evidence changes. Use of it is at your own risk.

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