back pain, Pars Defects


Pars defects is also know as spondylolysis, this is a stress fracture of the bones of the lower spine that occur due to overuse. This is the most common cause of lower back pain in children and adolescents.

There are two types of treatment for spondylolysis: treatments for active spondylolysis and treatment for inactive spondylolysis.


Treatment program for active spondylolysis is usually a combination of the following:

  • Exercise that is controlled and builds gradually over time.
  • Bracing to immobilize the spine for a short period to allow the pars defects to heal.
  • Pain medication and/or anti-inflammatory medication, if needed.
  • Stretching, beginning with gentle hamstring stretching and progressing with additional stretches over time.
  • On rare occasions, spondylolysis that is not healing or that have a neurological components may require surgery to provide internal fixation and stability to the area. Usually two procedures are performed as part of the same surgery:

(a) A spinal fusion to provide stabilization of the affected area, and

(b) A decompression laminectomy which reduce irritation and inflammation in the area.


In most cases spondylolysis will be discovered long after the pars defect has been already healed. The condition is often referred to as chronic inactive spondylolysis and may produce symptoms of chronic or recurring lower back pain or discomfort. Medical research suggest that once the lesion has healed and becomes inactive, the likelihood of significant progression is minimal and rarely does slippage require surgical intervention.

For discomfort or pain associated with chronic inactive spondylolysis the following treatment is available: pain medication, chiropractic or osteopathic manipulation, physical therapy and exercise. There is some case studies to show that manipulation will often provide temporary pain relief for patient. It is important to note that any practitioner performing manipulation must take into account that spondylolysis means that there is a potential unstable area on the spine so caution and skill are very important.