VERTEBRAL COMPRESSION FRACTURE.

Introduction

Vertebral compression fractures are a common complication of osteoporosis, which is characterized by the loss of bone mass. These fractures can cause significant pain, disability, and potentially serious complications. Often, a fall, cough, or lifting a heavy object can lead to a fracture in the back bones, resulting in sudden and severe back pain. These fractures more commonly occur in the thoracic spine (middle portion) and lumbar spine (lower portion).

Pain of Compression Fracture

A compression fracture can present with very intense back pain, typically caused by instability or motion of bone fragments at the fracture site. While this pain may diminish naturally in a few weeks, it can last as long as 2-3 months, or sometimes longer. Traditionally, people with severe pain are treated with rest, activity modification, pain medications, and braces. Doctors may also recommend additional medications to prevent subsequent fractures.

Symptoms and Causes

Symptoms

  1. Back Pain: This can come on suddenly and may become chronic, developing anywhere between the shoulders and the lower back.
  2. Decreased Mobility: Reduced flexibility in the spine, making it difficult to twist or bend.
  3. Loss of Height: As the vertebrae compress, the back curves and height may be lost.
  4. Pinched Nerve and Nerve Damage: This can cause tingling, numbness in the back, and difficulty walking.

Causes

Most compression fractures result from osteoporosis. As bones naturally weaken with age, the vertebrae in the spine become flatter and narrower, making them more prone to fractures.

  • Moderate Osteoporosis: A compression fracture might result from a fall or an accident.
  • Severe Osteoporosis: Daily activities such as getting out of a car, sneezing, coughing, or twisting suddenly can cause fractures.

Physiotherapy Management

Pain Reduction

A physical therapist may use various treatments, technologies, and manual (hands-on) therapy to control and reduce pain, helping to avoid the need for pain medications, including opioids.

Movement Guidance

Your physical therapist will teach you which movements and exercises to perform gently and which to avoid. Avoiding certain movements will promote healing and help prevent future fractures or collapse of the vertebrae.

Flexibility Exercises

Gentle spinal range-of-motion exercises for the neck, middle, and lower back, as well as the hip and shoulder areas, may be taught to improve flexibility.

Strengthening Exercises

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

Posture and Spine Sparing

Your physical therapist will teach you how to maintain safe posture and spinal positions to protect the vertebrae from undue stress while sitting, standing, walking, and even sleeping. Additionally, you will learn proper ways to perform tasks at home, such as bending and lifting.

Conclusion

Vertebral compression fractures can cause significant pain and disability, especially in individuals with osteoporosis. However, with the right physiotherapy management, pain can be reduced, mobility can be improved, and future fractures can be prevented. If you suspect you have a vertebral compression fracture, consult with a healthcare provider to get a comprehensive treatment plan tailored to your needs.

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