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Vertebral Compressed Fracture

Intro

A doctor should evaluate any  back pain in these cases:

  • Any elderly person
  • A person with cancer  
  • Anyone whose pain is exactly the same at rest as it is during activity
  • A person with unintentional weight loss

Seek medical help at a hospital's emergency department if you have the following symptoms in association with back pain:

  • Loss of control of urine or defecation
  • Severe pain, numbness, or weakness
  • High fever
Self-Care at Home
  • Rest
  • Pain relief
  • Apply ice to the injured area for the first week, then heat or ice, whichever feels better. Ice should be applied in the following fashion: Place the ice in a bag, wrap the bag in a towel, and then apply to the injured area for 15-20 minutes each hour. Heat applied in the first week after an injury draws more fluid to the area, thereby increasing swelling and pain.
  • When allowed by your doctor, a home stretching and strengthening program
Other Therapy

Percutaneous vertebroplasty: This is a relatively new procedure in which a needle is inserted through the skin by a specialist and a cement or "biomaterial" compound is injected into the vertebra with the osteoporotic fracture. Studies using this technique have shown promise in relieving chronic pain associated with osteoporotic fractures.

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Follow-up

Follow the instructions exactly as given by the doctor, and ask questions if you are unsure what to do.

  • Take the medications as prescribed.
  • Apply ice for the first week. A good rule of thumb is to place the ice in a bag, wrap the bag with a towel, and then apply the ice for 15-20 minutes every hour. After the first week, either ice or heat may be applied. Apply the one that makes the injury feel better. Applying heat in the first few days after an injury draws more blood to the injury site, thus increasing swelling and pain.
  • Avoid strenuous and painful activities until cleared by your doctor.
  • See your doctor frequently to ensure that the bones are healing.
Prevention

The most important method of preventing vertebral compression fractures is to prevent osteoporosis.

  1. Eat a well- balanced diet.
  2. Regular exercise including weight-bearing and strength-training exercise has been shown to increase the strength of bone.
  3. Stop smoking. Tobacco smoke has been shown to weaken bone.
  4. All people at risk for Osteoporosis  should take calcium and vitamin D supplements.
  5. In women past menopause, estrogen replacement therapy is likely indicated to prevent osteoporosis. Two relatively new medications, alendronate (Fosamax) and risedronate (Actonel), have been shown to reduce the development of osteoporosis. They have also shown promise in decreasing the rate of bone loss in those who already have osteoporosis.
  6. If you are on daily steroid therapy for another medical condition, discuss with your doctor methods of reducing the dosage of your steroid medication because decreasing the doses reduces the chance of developing osteoporosis. In some medical conditions that require steroid therapy, other medications may be useful in reducing your steroid dosage.
Outlook

The back fracture should heal in most cases without problems. However, severe fractures may need surgery to keep the spine in alignment. Also, a pathological back fracture may not heal because cancer may be present.

A person who has a fracture caused by osteoporosis can decrease the chance of further fractures with adequate dietary supplementation (calcium), exercise, and hormone replacement, if indicated.

Fractures causing chronic, severe pain benefit from a multidisciplinary approach that may include the primary medical doctor, an orthopedic or neurosurgeon, physical therapy, and pain clinic referral.

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