I fractured T7 in March of 2017. Brendas vertebral compression fractures changed her lifestyle. Most of the fractures occur at the thoracolumbar junction. All the best, Margaret. Avoid sleeping in a recliner. Medium-firm mattress is often recommended but you have to find the one that is right for you. Radiographic criteria for VCFs include a decrease in vertebral body height of at least 20% or a 4-mm reduction from baseline height. I cover important topics related to osteoporosis exercise including: Enter your email address and I will start you on this free course. Thank you again. Compression fractures happen when there is too much pressure on the vertebra. [5]. Women and men who have not exercised before think that something has gone wrong. I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. I am going for Kyphoplasty in 10 days time. Both of these items are covered in this blog post and in the Exercise for Better Bones program. In the next lessons I cover in more detail what types of movements have been shown to increase the risk of both wedge and biconcave vertebral compression fractures. It is recommended to wear the brace/orthosis for 6 to 12 weeks, followed by supervised physical therapy. Before the compression fracture, Brenda was the Energizer bunny. Im glad you are doing well. Mechanical low back pain (Clinical pain presentations), Primary OsteoporosisSecondary osteoporosis, A plain radiograph may be all that is necessary for a majority of compression fractures, especially if one proceeds with conservative, medical management, DEXA scan: Roughly half of patients with vertebral fractures have. Follow an exercise program designed for people with osteoporosis. A pre-existing spinal fracture: Having one spinal fracture greatly increases your chances of having another. This often happens to the front of the vertebrae but not the back, causing you to stoop forward over time.Compression fractures are caused by: Osteoporosis, a weakening of the bones that can occur in postmenopausal women and older men. Hi Margaret, Thank you for all the helpful information on osteoporosis. That initially helped with the general pain. (To follow this tutorial you will have to play the embedded video because I will refer to images and diagrams as I speak through the talk.). The mean age or the average age for the women in this study were 49 to 60 years of age. Its a reminder to keep upright. The vertebrae itself is actually quite a bit shorter in stature than the vertebrae above and below it. Safe compression fracture exercises and safe movement are critical to reducing your risk of another compression fracture. Studies have shown that exercises that involve flexion increase your chance of spinal fracture. 1173185, Zdeblick TA. It appears that you are not alone in your question. I have to sleep in a hospital type bed due to the fact of not being able to lay flat, and sleep at nearly a ninety degree angle. My pain lasted approximately six months each time. It is so very important to remind yourself that this can happen. As well the safe stretches and certainly the Beginner Balance exercises would all be appropriate and helpful for you at this time. As time goes on, your spine has to work a little harder if you have compressions because the forces in the spine have changed. A compression fracture of the lumbar spine is also known as a wedge fracture. Diagnosis and management of vertebral compression fractures. If the fracture occurs from a traumatic injury, the skin over the affected vertebra may appear red. If you currently have a 30% compression of your vertebral body, it can become 40% or even 50% compressed. Heat seems to help. Brenda uses a Weighted Kypho Orthosis Vest for walking, while preparing her food and any activity anything where she is standing around a long time. It increases the trunk muscle strength in patients with osteoporotic fractures in the vertebrae. The Role of Trunk Musculature in Osteoporotic Vertebral Fractures: Implications for Prediction, Prevention, and Management. A vertebral compression fracture can create stress in your relationship. Thank you very much for posting. I too have been very mindful of bone strength and my genetic vulnerability way before menopause. When Brenda prepared for todays talk, she realized how frustrated she was with her situation. I had been advised many years previously to take ibuprofen and paracetamol alternatively every 2 hours (with limits on total amounts taken in 24 hours). Glad you are walking, it is good for our body and spirit as well as being good stress management tool. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. I started Prolia last December with my second injection being in June of this year (2020). With biconcave fractures the top of the vertebral body takes on what looks like a smile while the bottom of the vertebral body takes on a grin. I will share your comment with Deborah. The first thing she would tell her younger self (in fact, what she has told her daughters) is that you have to be really fastidious, as much as you can be, about choosing your general practitioner, or your family doctor. Exercises you should avoid if you have osteoporosis. WOW! Brenda concluded that her bones were healthy because of her exercises, diet and Prolia injections. I have been searching and searching for some real information about living with compression fractures. Thank you. DOI: Goldstein, Christina L., et al. So its a personal decision that youre going to have to make to keep you safe and feeling well. Many fitness professionals are not trained to deal with a person with osteoporosis. The following are six symptoms of a compression fracture: If you have any of these symptoms, especially a combination of these symptoms, you should ask your doctor to assess you for a vertebral fracture. Brenda finds that ittakes the 10 minutes for her body to release and relax into the stretch. Hi Donald, There is a ton you should do or rather should not do. Get as flat as you comfortably can so as to take weight off your compressed vertebra. I wish you were in B.C. No specialist/MD i have seen will recommended Kyphoplasty, due to the volume of fractures I have, and even so much as a brace recommendation has been hard to yield from anyone, due to me having both Lumbar & Thoracic fractures. If you do not have the flexibility in your hips to do so you can get get a sock helper. Hi. Be bone health aware in terms of not just milk, but other sources of calcium as well. In younger people who don't have osteoporosis, compression fractures usually result from trauma (such as a car accident) or cancer. 13 It is . VCFs most often occur in the thoracic (middle) and lumbar (lower) areas of your spine. When youre in the recovery stage, physical intimacy is best expressed in alternative ways than intercourse. Rest is not recommended, its important that the patient remains active. Margaret has trained physicians, Physical Therapists and other healthcare staff at Genesis Rehab Services, Jewish General Hospital in Montreal, Charles Lemoyne Hospital in Montreal, Ottawa Hospital Rehabilitation Centre, Bruyere Hospital in Ottawa, Osteoporosis Canada, and West Carleton Family Health in Ottawa. Thank you for this video. Exercise for Better Bones is an osteoporosis exercise program that provides exercise programs for people at different fracture risk and activity levels. These movements are putting them at risk of a compression fracture. I am afraid of making things worse. All she can do now is deadhead plants. They have also demonstrated that exercises that involve the combination of flexion and rotation increase fracture risk even more than flexion exercises only. But I am glad it helped you! Ill ask them to get x-rays because Im trying to convince them to move safer. Key components of an osteoporosis exercise program. They want me to start a Forteo which is very expensive which my copay is $900 a month. Do I recommend specific exercises for my clients with compression fractures? thank you for sharing your experiences it helps and makes me feel not so isolated. I went to a chiropracter I thought that would sort everything wrong it got worse. These can be broken into two major groups: one set of exercises for posture and flexibility and the other for strengthening. But it is relieving to see that people are finding ways to go on. Compression fractures are not static. My suggestion is to use them appropriately for tasks that you actually need that extra support such as when you work in your garden. A repeat DEXA showed that she had improved, so she discontinued her Prolia injections in the spring of 2015. Thanks! [2], There are several classification systems for VCF, Compression fractures are typically diagnosed by lateral radiography of the vertebral column, with or without anteroposterior views. With time I encourage you to progress the chest stretch by lying on your back over a rolled-up blanket. It helps take the ache away. I have two lumbar fractures, L1 and L5,from an unfortunate movement I made last week. April 2016,Volume 27,Issue4,pp 1459-1467, EvstigneevaL et al. This is also known as a Dowagers Hump, buffalo hump, or neck hump. Patients with an acute VCF may report an abrupt onset of. She is now paying the price. Brenda never lets a day go by without doing her targeted stretches. VCFs were identified in the thoracic (n = 6), lumbar (n = 4) and cervical (n = 1) spine. She was diagnosed with osteopenia. Following a compression fracture in the spine, patients are often instructed to wear a brace for 6 to 12 weeks, followed by supervised physical therapy exercise. I think that is very important. Many of their techniques are contraindicated for individuals with osteoporosis. Yoga and pilate moves need to be practiced with caution and should be practiced under the supervision of instructors who are well trained in the precautions that need to be carried out for individuals with osteoporosis and low-bone density. I will often see women carry heavy purses and they go to sit down and theyll rotate and drop their purse to the side. Movements like create a very compressive load and put your spine at risk of a compression fracture. What is unusual is that the pain comes later in the day and it is on the right side of my abdomen in the front (just under my ribs). A number of bones and tissues make up each vertebra, including intervertebral discs that act as shock absorbers; the "bumps" in the spine, called transverse processes; and lamina, which protect the spinal canal. She became more careful, watched the calcium in her diet, her vitamin D levels, and continued her exercise classes. My first piece of advice regarding sex with compression fractures is to consult with your physician before engaging I a physical activity such as sex with your partner. You should either consult with a Physical Therapist close to home or consider this service. She has always enjoyed gardening, bi-weekly exercise classes, and daily walks. Be sure your mother is very careful with her activities of daily living. These have been taken that away completely. But they do have a professional obligation to find out and to send you on to a specialist who does know. The illustration to the right shows the cross section of a vertebra of the spine. I asked Brenda knowing what you know now, what would you tell your younger self? Otherwise the vertebrae has healed itself in the compressed shape. He or she should be your strongest advocate in the medical system. In the photo above, Pat is bending forward in an unsafe manner. What has happened is that theres been so many forces that the disc is actually starting to push through the vertebrae. She is the proud recipient of the 2011 Award of Distinction from the College of Physiotherapists of Ontario for her significant contributions and achievements as a Physiotherapist. I cried watching this. They likened the healing to when a knuckle has a skin crack and if you keep bending it that it takes longer to heal. The pain is not in my back! I would GREATLY appreciate any advice you have in what type of expert/specialist I need to find that can help with my back and these fractures. 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. Will I ever be pain free?! Also, through the years, I have suffered rib pain from doing very innocuous things (like turning over in bed, or receiving a hug). It was very handy in the initial stages because everything seems to drop when you dont want it to drop. Even coughing, laughing, or sneezing can cause a compression fracture in someone with weakened bones. The physiotherapist (the one she saw before she came to see me) helped with the pain. It is important that you keep this in mind and I recommend that many people consider couples therapy during times of stress. Braces which extend to the sacrum are termed thoracolumbar sacral orthoses. Unlike people with sciatica, your back pain most likely will not be, if its from a vertebral fracture, will not be going into the leg. I think it is very important to have a physical therapist who specializes in PT for osteoporotic patients. So thank you very much for sharing this. The loading through trabeculae and the whole vertebral body is much more even and safe. 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. There has to be someone, somewhere, that has the knowledge you two incredibly sound and vertebral fracture educated individuals have, that can help me and advise me in what to do regarding any sort of treatments moving forward? Start at the thoracolumbar junction and extend to the promontorium of the sacrum. There are four subtypes for compression fractures. The location of the pain corresponds to the fracture site, as seen on radiographs. I asked Brenda to discuss the treatment she received after the diagnosis of her compression fractures. She is licensed to practice Physical Therapy in Ontario and California. Have a greater mobility in flexion and extension. Can you tell me where to purchase one? Exhaling thru pursed lips as he visualizes drawing up the big boys as they would say in Australia. The fracture-dislocation is a fracture in which bone and its accompanying soft tissue will move off an adjacent vertebra. Following surgery for relief of lumbar fracture compression injury or trauma, your doctor may suggest short-arc exercises that promote flexion and extension of the quadriceps, such as pelvic stabilization exercises like the pelvic clock, says spine surgeon Dr. Matthew Cubbage. Protein is one of the main building blocks. 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. If we want to stop the progression of forward flexing of the spine (kyphosis) that occurs because of the repeated wedge fracturing like we see in the image to the right, we need to do this at a stage ideally where the individual has not yet fractured. 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. Pain is still there but getting better. 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. But one has to stand up for ones rights and its their professional duty to find out if they dont know. Im 7 weeks in and wow this is so painful. When its not there, she can really feel the difference. In this tutorial, were going to look at why the lumbar and thoracic spine is more at risk than other bones in the body of a compression fracture. In fact, a recent study (3) states that about 12% of post-menopausal women will have a vertebral fracture but only one third of those will get the attention of a medical professional. 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. These curves look really pronounced in our illustration. I was told today that complete healing can take a year. Fortunately there were physicians who studied this issue. It will save a lot of time. When she starts to feel achy, she sits down for 15 minutes and puts it on. She could not lift a dish in or out of the oven. 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. Type B: The superior endplate is damaged. The wedge vertebral compression fracture takes its name from the shape that is created as the front or anterior of the vertebral body is affected. Once you get the okay from your physician you can start into the Posture and Beginner strength exercises in Exercise for Better Bones. 93% of the men who had their fractures diagnosed during the study reported back pain. It consists of five vertebrae known as L1 - L5. Does this sound normal to you? It subsides if I lay down. The clients think that they are doing things that are sound and right for them given the fragility of their bones. After the first 8 weeks of a new vertebral fracture you can gradually incorporate more extension exercises/movements into your day. I iive alone and shopping, doing dishes, cooking, laundry are all hard. I asked Brenda if either the physician that gave her the diagnosis or the initial physiotherapist who treated her told her that the compression fractures could get worse by how she moved. All tell me that the decline in strength impacts their quality of life.