Case Report: Postpartum Sacral Stress Fracture

Background: New mothers often experience lower back pain during the postpartum period, which is a rare but complex complication associated with sacral stress fracture (SSF) that increases specifically during weight lifting. Case Representation: This case study involved a 36-year-old Irish woman who presented to her general practitioner three weeks postpartum after a normal vaginal delivery. The patient reported pain in the left pelvic region and lower back, which intensified with weight bearing but diminished while at rest. Initial physical examination revealed slight midline point tenderness, and the Gaenslen test result was positive, indicating the presence of sensitivity at the sacrum. Clinicians suspected SSF, and MRI was performed to confirm the diagnosis. MRI resonance imaging revealed bone marrow edema confirming SSF; however, no fracture lines were observed. Therapeutic interventions included a conservative treatment regimen involving non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief and analgesics. Bed rest was advised, and bone supplementation was prescribed, given that lactation-induced osteopenia is generally experienced in postpartum females. The patient was placed for long-term monitoring and consistent follow-up, where weekly follow-ups revealed pain reduction, and three months postpartum follow-up indicated complete resolution of pain and regaining normal physical activity. Conclusion: Our findings highlight several important findings. Clinicians need to have an increased suspicion index for SSF, particularly in postpartum women, given that its symptoms are often confused with those of normal recovery. MRI has emerged as a gold standard for the accurate identification of bone edema, which is essential for definitive and timely diagnosis.