VERTEBRAL COMPRESSION FRACTURE

Introduction

Vertebral compression fractures are the most common complication of osteoporosis (loss of bone mass) and can be a significant health issue leading to a lot of pain, disability, and potentially serious complications. A fall, cough, or lifting of a heavy object may cause a fracture of the back bones. This can lead to a sudden onset of severe back pain. These fractures more commonly occur in the thoracic spine (the middle portion of the spine) and lumbar spine (the lower portion).

Pain of Compression Fracture

Compression fractures can present with very intense back pain, which is thought to be caused by instability or motion of bone fragments at the fracture site. This pain, if the fracture is allowed to heal naturally, can diminish in a few weeks but it can also last as long as 2-3 months and sometimes longer. Traditionally, people with severe pain are treated with rest and/or activity modification, pain medications, and braces. Your doctor will likely recommend additional medications to try to prevent subsequent fractures.

Symptoms and Causes

Symptoms

  1. Back pain, which can come on suddenly and last a long time (chronic back pain). It usually develops anywhere between the shoulders and the lower back.
  2. Decreased mobility or flexibility in the spine. You may not be able to twist or bend over.
  3. Loss of height as the vertebrae compress and the back curves.
  4. Pinched nerve and nerve damage, which can cause tingling and numbness in the back and difficulty walking.

Causes

Most compression fractures result from osteoporosis. Bones naturally weaken with age, causing the vertebrae in the spine to become flatter and narrower. Weakened bones are more likely to fracture.

If you have moderate osteoporosis, you might get a compression fracture from a fall or another type of accident. People who have severe osteoporosis can fracture a bone during daily activities. These can include getting out of a car, sneezing, coughing, or twisting suddenly.

Physiotherapy Management

Pain Reduction

Your physical therapist may use different treatments, technologies, and manual (hands-on) therapy to control and reduce your pain. These treatments can help you avoid the need for pain medications, including opioids.

Movement Guidance

Your physical therapist will teach you what movements and exercises to gently perform, and not to perform. Avoiding certain movements will promote healing and help prevent future fractures or collapse of the vertebrae.

Flexibility Exercises

Your physical therapist may teach you gentle spinal range-of-motion exercises for the neck, middle, and low back, as well as the hip and shoulder areas.

Strengthening Exercises

Your physical therapist will prescribe gentle exercises to help stimulate your bone strength and straighten the curve of your middle back. These may include upper- and lower-body, stomach, and back muscle-strengthening activities.

Posture and Spine Sparing

Your physical therapist will teach you how to maintain safe posture and spinal positions. This will protect the vertebrae from undue stress when you sit, stand, walk, and even while you sleep. You will also learn proper ways to perform tasks at home, such as bending and lifting.

Conclusion

Vertebral compression fractures are a serious complication of osteoporosis that can cause significant pain and disability. Understanding the symptoms, causes, and available treatments, particularly through physiotherapy, is essential for effective management and recovery. Physiotherapy plays a crucial role in pain reduction, movement guidance, flexibility, and strengthening exercises, as well as posture training to prevent further injury. If you or someone you know is suffering from a vertebral compression fracture, consult with a healthcare provider to develop a comprehensive treatment plan that includes physiotherapy for optimal recovery and long-term bone health.

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