Did you know that you can get a spinal fracture by simply stepping off a curb, sneezing, lifting a small pet, just getting out of bed.
Fractures due to osteoporosis are much more common than many people realize. After age 50, one in two women and one in five men will have an osteoporosis- related fracture in their lifetimes.
The most common type of fracture linked to osteoporosis is a vertebral compression fracture (VCF)..a break in the vertebra of the spine. VCF’s are more common than hip or wrist fractures..often are painful…can lead to loss of height and a stooped back… So why do a shocking two-thirds of VCFs go undiagnosed and untreated.
Osteoporosis can weaken the bones so much that even routine activities or seemingly simple movements can cause a spinal fracture. Sudden, non-radiating pain ranging from mild to severe is usually the first sign. The pain is often mistaken for arthritis or a pinched nerve. Because many people with osteoarthritis don’t even know they have it. VCFs simply aren’t on their radar.
An undiagnosed VCF will often heal on its own, with the pain diminishing in 6 to 8 weeks. You don’t want this fracture to go undiagnosed. One VCF increases the risk for a subsequent VCF fivefold. Multiple fractures result in a loss of height and stooped posture. With each untreated VCF, the spine can get a few millimeters shorter. If the vertebrae in the upper back and become wedge-shaped, the spine curves abnormally causing a kyphosis, a rounding of the back better known a a dowager’s hump.
If you are a man or women over are 50 who is experiencing new unexplained mild-to-severe midline back pain that doesn’t go away in a day or two, you need to see a doctor. Your primary care physician will perform a physical exam to check back tenderness and likely will order an x-ray to confirm the diagnosis,following up with a CT scan or MRI to evaluate the problem and advise you on the best treatment for your specific situation.
TREATING THE PROBLEM !!
If the pain and loss of function from a VCF are mild, conservative treatments are usually recommended:
- A few days of bed rest.
- Pain relievers
- A hyperextension brace
- Physical Therapy
Patients whose pain doesn’t resolve in 2 – 3 weeks with treatment above may be candidates for a minimally invasive procedure called “vertebroplasty”. The outpatient procedure takes approx. 45 minutes while the patient is typically conscious but sedated. The doctor injects bone cement into the fracture. The cement not only stabilizes the fractured vertebra, it also prevents nearby nerve endings from causing pain. Studies show that 75% to 100% of patients enjoy good to moderate pain relief and increased mobility quickly, often the next day.
With “kyphoplasty” a modification of vertebroplasty, a balloon is inflated in the fractured vertebra to create a cavity that is filled with cement. This procedure may offer a better chance of restoring height loss. In general,vertebroplasty and kyphoplasty are safe when done by experienced physician. Interventional radiologists and neuroradiologists often do these procedures. Like all invasive medical procedures, these treatments do have risks such as infection or bleeding. In rare cases the cement can leak into the spinal canal, causing nerve compression, or travel into adjacent veins which can lead to blood clots in the lungs or heart.
Preventing future fractures: Treating the underlying osteoporosis to help prevent future fractures is crucial. Ask your doctor for a bone mineral density test called a DXA or DEXA. Options include prescription medication..calcium and vitamin D supplements ..weight bearing exercises to improve bone strength and other exercises to build core strength.
Multiple clinical trials have shown that early treatment of osteoporosis can increase bone mineral density by 5% to 15 %, reducing vertebral fracture rates by 40% to 70 %.