Immediate physical therapy superior to rest for adolescent lumbar spondylolysis in randomized trial (bjsm.bmj.com)

• Immediate PT group started therapy 6 days post-diagnosis vs. 28 days for rest group.
• At 1 month, immediate PT group had 21-point better Micheli Functional Scale scores.
• Immediate PT returned to sport 38 days sooner (74 vs. 112 days median).
• Low back pain recurrence was 3% in immediate PT vs. 29% in rest group.
• MRI healing at 3 months did not differ between groups.

"A multicentre RCT of 64 adolescent athletes with active lumbar spondylolysis found that starting physical therapy immediately (within 7 days) led to significantly better pain and function at 1 month, a 38-day faster return to sport, and fewer low back pain recurrences over 12 months compared to initial rest followed by therapy. Healing on MRI did not differ between groups."