The indications for surgical management of lumbar compression fractures are discussed in Surgical Intervention. Brenda had to use a walker for the first time ever in her life after the compression fracture. Exercise is an essential ingredient to bone health. Four months is still early days. When she starts to feel achy, she sits down for 15 minutes and puts it on. The PT therapists Ive consulted with are too scared to even advise how to brush my hair or teeth correctly for my issues, as for fear a light breeze my way could finish breaking me completely. Compression fractures of the spine generally occur from too much pressure on the vertebral body. Could these rib pain incidents be related to osteoporosis? As far as cold the physician who came up with RICE (rest, ice, compress and elevate) recently wrote a book explaining how he wished he had never suggested Ice. She finds that the prolonged fascial stretches make her feel good. Every time she improves in her exercises, her muscles are activated; and every time those muscles are activated, she is stronger in whatever she does, whether its getting off the toilet, getting out of a chair, getting out of bed in one smooth motion. I strongly recommended that you speak to the bone specialist that is seeing you (rheumatologist or endocrinologist) to help you weigh the pros and cons. Others have asked and although Brenda would love to have the time and energy to reach out individually lifes challenges do not allow her to do so. If the cold doesnt help, is it necessary ? I unfortunately do not know of anyone in Winnipeg. Are there any studies done with that scenario? Loved reading your blog and when home from our winter home will be ordering your books. But what exercises should you do and which ones should you avoid? Once it's done you'll be taken to a recovery room. This is likely the best sleeping position for osteoporosis of the spine: To learn more about how to get a good nights sleep if you have a compression fracture, visit my page dedicated to better sleep. Hi Sue: Glad to hear that you have found the post and Brendas story. Wedge compressions are most commonly seen in the mid back, around the level of the lower angle of the shoulder blades. You can use one for the garden for picking up things like sticks. I went to a chiropracter I thought that would sort everything wrong it got worse. Weighted vesta are a popular exercise device for many people with osteoporosis but should you wear one if you have a compression fracture? Brenda has had to embrace the crumpled look because everything hurts around her middle. And they wont know everything. Note how our model Aline, in the photo, is performing the Prone M (also referred to as Floor M) exercise by elevating her torso upwards and creating an extension of her back. Are stacked together and can provide a movable support structure while also protecting the spinal cord from injury. Examples include the Jewitt, cruciform anterior spinal hyperextension, and Taylor brace. This site uses Akismet to reduce spam. I walk approximately 5-6 miles daily. She has said walking and stretching, but not what kind of stretching. Core strength and osteoporosis why is core strength important if you have osteoporosis? We learned why your spine is at risk of a compression fracture and about physical therapy compression fracture treatment. After that, continue through to the Active strength exercises. When the test is positive there is reason to rationalise and refer the patient for a MR scan. I just fractured my fifth thoracic vertebrae from severe osteoporosis. Everyone is different and the exercises will need to be broken into groups and delivered at apace that works for you. You should not hesitate to purchase Exercise for Better Bones. The incidence of thoracic compression fracture is the highest among all parts of the spine because this area is the one where the postural stoop (or kyphosis) will occur. I compression fractured my L4 7 days ago. Hi Donald, There is a ton you should do or rather should not do. Brenda concluded that her bones were healthy because of her exercises, diet and Prolia injections. Anyway, this site remains very helpful in terms of my thinking about what I can and cant do. All the best to you and your Mum. You should either consult with a Physical Therapist close to home or consider this service. The decision to take a pharmaceutical needs to be discussed with your health care provider, including your PT. It is recommended to wear the brace/orthosis for 6 to 12 weeks, followed by supervised physical therapy. It appears that you are not alone in your question. You can see in this vertebral body that there are large pits. Just because your spine has compressed 70%, it doesnt mean that it cant keep compressing. Bend both your knees. In addition, the brace allows for less fatigue of the paraspinal musculature and muscle spasm relief. With time I encourage you to progress the chest stretch by lying on your back over a rolled-up blanket. Also, through the years, I have suffered rib pain from doing very innocuous things (like turning over in bed, or receiving a hug). Vertebral compression fractures (VCFs) are the most common complication of osteoporosis, affecting more than 700,000 Americans annually. Exercises you should avoid if you have osteoporosis. L1, and L4. Compression fractures of the spine usually occur at the bottom part of the thoracic spine (T11 and T12) and the first vertebra of the lumbar spine (L1). Sixteen percent in comparison to 90%. Studies have shown that both drugs and even the combination of the two drugs helps to protect you against more fractures. As will the vitamin and HRT regimes I believe. I have created a page of Recommended Products you can consult. Brenda found the strengthening exercises that I have given her to be initially were very hard to do even though she was fit. This material is comprehensive and very helpful. The first video (below) is 25 minutes long. Gardening was a stress reliever before, now its a source of stress. This is also known as a Dowagers Hump, buffalo hump, or neck hump. The Role of Trunk Musculature in Osteoporotic Vertebral Fractures: Implications for Prediction, Prevention, and Management. Build up gradually and stay as strong as you can. After finally seeing a spine specialist today and doing some more reading on the web I can now see that I am being too impatient, especially as I did not know until it was detected 3 weeks ago that that was my problem. VCFs most often occur in the thoracic (middle) and lumbar (lower) areas of your spine. Brenda did the wrong exercises with gusto. As mentioned earlier in this post, Brenda uses a heating pad a lot. If you have the protein, which is acidic, make sure you increase you intake of fresh fruits and vegetables which are alkaline and help balance the acidity in protein. Elsevier, 2005. Your email address tells me you have been very active throughout your life. Thank you Jean, Hi Jean, You are most welcome. The illustration shows the normal curves in our spine. Check with your doctor about the best weight -bearing exercises for you, such as: Walking Yoga. And is there a method for tying my shoes? The lowest lumbar vertebra is situated just above the sacrum, or triangular bony plate that extends from the hip line to the middle of the buttocks. In fact, she did not even know that one of her compression fractures, a T9 compression fracture, was compressed 70% and could not be fixed. This is because the nerves that exit the thoracic spine from T2 to T12 wrap around the torso to innervate the back, sides, and front of your body as well as your organs. I cried for two days, it seemed like the life I had and my future Latin dancing, backpacking, gardening old age (I called it late middle age) was going to turn into a recliner-centered existence like my mums. I dont like the idea of any but. She was able to manage the pain because she had some over-the-counter pain medication with her. However, this does not distinguish whether the anterior or posterior column is involved. Get Top Tips Tuesday and The Latest Physiopedia updates, The content on or accessible through Physiopedia is for informational purposes only. Hello, a question about DXA scans if you can answer.subsequent to this whole discussion I had a DXA scan that seemed to indicate that my bones were actually in good shape for a 30 year old, much less for an almost 63 year old like me. If your BMD numbers have been worsening but you feel that you could improve your nutrition and your exercise to reduce bone loss then it is an approach worth taking regardless of whether you take pharmaceuticals. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). I have asked many health care providers and no one has ever heard of this type of residual pain from a thoracic compression fracture. He has to regain trust in his body. Within the book, Exercise for Better Bones, you will find a link to over 30 + suggestions on daily activity modifications that you should consider. As bones in the spinal column grow weaker or collapse due to disease or injury, they compress against other bones, nerves and tissues, causing limited movement and range of motion, pain and numbness. I have a T6 compression fracture of indeterminate age, according to the x-ray tech, but I think it is at about 3 months old and have been wondering why it still hurts. Diagnosis and management of vertebral compression fractures. My physio has given me stretching and strengthening exercises to do. Thank you! Hi Johanna, So glad that Brendas story was helpful to you. Anteroposterior and lateral radiographs of an L1 . We hold every comment posted on our site and review it before either responding to it, deleting it, or publishing it. I wrote a detailed post on osteoporosis exercises to avoid. Products and services. The physiotherapist used hot pads, electrical pulses that stimulate the muscles, acupuncture, and a minimal amount of ultrasound. I answer each of these questions in this blog post. Learn how your comment data is processed. All the best, Margaret. The key findings and conclusions were: The studys main author, Dr. Howard Fink, concluded: Back pain is the most common symptom (of compression fractures). The study results are similar to findings in elderly women. Ive had four compression vertebral fractures so sorry for your pain and I sympathize with you. I am glad the combination of medications helped you. Thanks! The biconcave vertebral compression fracture, like the wedge fracture can have different levels of compression. I have really appreciated all the tips you have shared and will definitely look into some of the equipment you suggest. Recent studies have questioned their effectiveness. I am a 39 year old woman, whom has been sincerely stricken down in the prime of my life, with vertebral compression fractures. Im university faculty, and it struck me today that if we werent teaching from home because of the pandemic I would have had to take time off, I dont know how I could have gone into the classroom. During a a vertebral kyphopasty surgery, the surgeon re-inflates the vertebra with kyphoplasty and then injects a form of cement into the vertebral body. When its not there, she can really feel the difference. Hi Karen, thank you for sharing your story. Too severe for her pain medications to suppress. Wear the same thickness of clothes you would at night. A routine DEXA (Dual-Energy X-ray Absorptiometry) test and FRAX score, in 2011, showed that Brenda had some bone loss. I instructed him on body mechanics and to avoid forward bending and twisting his back. Thank you for ordering Margarets book. Certain medications: eg oral steroids, anti-depressants, diabetes drugs. I agree that it is very important that your Dr has knowledge and experience of Osteoporosis and will refer you without a battle to the experts. (Level of evidence: 2A), Meunier PJ. Two different doctors seen within the first week of my T11 20% compression fracture, and all they said was take painkillers as needed and then started to talk about Prolia. I could not sit around even if I wanted to I had to keep moving so my back was not cramping and seizing up. I sincerely live in near DIRE back pain. Brendas story shows that every persons experience with compression fracture is going to be different. Hi Brenda, Thank you for sharing your story and for your kind praises. To get in bed, get in a sitting position. For some with minimal compression(s) in the mid thoracic spine, little may change for you. I am quite active and have not had any height loss or fractures since I was seen by a specialist in 2001.T5 is stable. Exercise and movements during the day that put our spine in flexion are implicated. Im 7 weeks in and wow this is so painful. My Physical Therapist recommended it to me. It subsides if I lay down. Mum is usually a fast healer. My ribs were not fractured, but it took several weeks for the pain to resolve. I had never hurt my back before so had no idea what to expect. Thank you again. What exercises build bone and which ones reduce your chance of a fracture? I am 60 years old. By the end of this tutorial, youll have a good understanding of what movements, be it in yoga, pilates, in an exercise class or movements around the house, that you should modify. Any injury that changes the shape of a lumbar vertebra will alter the lumbar. They should listen carefully, they should be able to communicate well to you, so that if you dont understand the medical jargon that they break it down for you. Margaret is the author of three books on osteoporosis and exercise. The men had enrolled in the Osteoporotic Fractures in Men study between 2000 and 2002. The mean age or the average age for the women in this study were 49 to 60 years of age. Dr. gave me back brace and ask me to visit him in 5 weeks. These were the findings. All the best, Margaret. The thought behind that is that for a lot of things that we do in life such as picking out the laundry, reaching forward, coughing, sneezing, involves a lot of flexion. Margaret. My GP, an internal medicine specialist, has began slowly tapering me off of the high dose steroids, introduced vitamin D and hormone replacement therapy to my daily regime, and as well started me on the first yearly/bi-yearly round of the IV infusion medication Reclast. Manypeople are not aware that they have a compression fracture. The Bennell study (2) looked at the effects of compression fracture exercises and manual therapy on physical impairments, function and quality-of-life in persons with osteoporotic compression fractures. Heat seems to help. I also have lost 3 inches in height which l also found stressful. Start at the beginner level, gradually work your way up, see what your body allows you to do, and maximize the weight that you can lift safely. I wish you were in B.C. Theimportance of good body mechanics and diligence during your exercises is really important despite having that type of intervention. The heating pad is nice when youre taking your break before bed or taking siesta in the afternoon, for example, to bring some blood flow to the muscles and give them a little break throughout the day. Journal of Clinical Neuroscience 2006; 12: 31-38 (Level of Evidence 1B). Low-impact aerobic exercise like walking may be suggested by your physical therapist, but will depend on your progress and prognosis following injury or pain as well as what caused the compression fracture in the first place. After the first 8 weeks of a new vertebral fracture you can gradually incorporate more extension exercises/movements into your day. Osteoporosis International. Osteoporos Int. There are several medical management methods to treat a lumbar compression fracture.Before anything else you need to control the pain: NSAIDs are often first-line drugs for back pain as they do not have sedating effects. Third group did a combination of flexion and extension exercises. As a result, they start to fracture. It subsides if I lay down. A fracture has an influence on the quality of life and the disability can last at least 5 years and thepain for2-4 years. Fracture types. In fact, my wife has recently had to start dealing with a compression fracture, so hopefully some of these techniques can help while we look for a chiropractor. It is a very good time to work on the breathing (as discussed in the book and on the site) as well as to ensure you are doing all your daily activities with utmost care and good body mechanics. She states that her life went from white to black a 100% change in her life. Compression fractures happen when there is too much pressure on the vertebra. Two compression fractures and Im afraid to do much. How you get up in the morning, how you choose to move a certain way, how you dress, how you tie your shoes, how you garden all of those things allow you to be in control and avoid your compression fracture to become more compressed. I am now working on spine and upper body strength especially and have seen a physio therapist who has an interest in osteoporosis. In early stages of injury, I understand. It increases the level of calcium in bones and can also relieve pain at the site of a fracture. Hi Nana, If he is within his 8 week healing window you then reinforcing good body mechanics is a great start the next step might be to start with teaching him good breathing techniques that would help with his anxiety as well as core stability. [1], Note- if the patient continues to have a lot of pain, or there is no progression at all, it is advised to send the patient to a doctor or preferably an orthopedic surgeon for a review and possible surgery. (Im 69 years old and need to do whatever I can to keep upright.) Meanwhile, my doctor has advised on what I should NOT do, but not what I CAN do. thank you for sharing your experiences it helps and makes me feel not so isolated. Lets take a closer look at what happens to your spine when you do flexion exercises or perform activities that cause a flexion motion. I got your book from library and love it. She may know of others like your son who have had Prolia injections since this is her area of interest and study. Use a pillow under your knees/legs when sleeping on your back. Decrease your pain at rest and with movement. This anatomical structure offers them the opportunity to bear the whole upper body. Then ask for medical certificate for time off work. A compression fracture is a type of broken bone that can cause your vertebrae to collapse, making them shorter. [5]. Axial compression causing burst fractures. Consider wearing a waist belt to support the space between your lower ribs and pelvis. Desperate to know what really is causing all this and how I can best help myself. Brenda indicated that the best compression fracture Physical Therapy treatment option for her has been myofascial release. Extend one foot towards the ceiling as you support it with the belt. The weakened trabeculae in osteoporotic bone cant withstand those excessive forces. What else can I tell him? They also taught me about how to pick things up, laying in bed, etc. The weighted kypho-orthosis vest helps her walk more upright because it counterbalances the weight of her head and allows her to control where her posture is taking her. I bought a brace and am taking tylenol, and using Lidocaine patches, The pain is difficult. It is invaluable. Patients with an acute VCF may report an abrupt onset of. The hip bones are lifted or tilted downward or shifted from right to left in a clockwise direction as directed by your physical therapist. We talk through modifying activities that include how to safely feed their cat, etc. Increased pain when the area of the fracture is touched or gently pressed. Here she details each of the parts of her life that have been affected by her compression fracture and how she has had to accommodate the pain from the compression fracture. The neck, calf, hamstring and quadricep exercises done as outlined in Exercise for Better Bones would be safe to do. Ive been thinking about some different options for my grandmothers osteoporotic fracture treatments, and I think that being able to get some help would be good. Rather, it is meant to inform you that it is in your control to help yourself reduce the further risk of a compression fracture. There are four subtypes for compression fractures. The world is not going to fall apart. Im glad you talked about being able to use heat pads and I think that being able to try that would be good. I am waiting for an appointment at the spine clinic to see if I am a candidate for vertebroplasty or kyphoplasty. To get out of bed, log roll onto your shoulder and then push yourself up with your hands until you are in a sitting position. With it she cannot bend, twist, or pick up a stick. Your situation does not sound unusual. She uses it for support when sitting in a chair because it helps cushion the lumbar area. Brendas genetics and family history of osteoporosis were red flags indicating that she might have some issues with her bones sometime in the future. It says my comment is awaiting moderationwhat does that mean? We identified six symptoms that you might have a compression fracture. Once she got the clean bill of health, Brenda planned a dream holiday for her and her husband a five week trip to Africa. I have seen countless specialists for these fractures, all of whom say theyve never seen such, and in turn are at a loss on how to advise any sort of short or long term treatment plan. Any advice? If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program. If that person is not accessible, then I recommend you start with the Posture Exercises outlined in my book, Exercise for Better Bones. She is putting a lot of force on her spine, especially in her mid back, through this position. Be sure you communicate openly with your physio so that she/she can ensure that all the exercises you do do not increase our pain. Thanks for your thoughts. But I am glad it helped you! I do have your book and have flagged all the exercises you recommended. [Epub ahead of print], Sinaki M, Mikkelsen BA, Postmenopausal spinal osteoporosis: flexion versus extension exercises, Arch Phys Med Rehabil.