Vertebral Compression Fracture
WHAT YOU SHOULD KNOW:
- A vertebral compression fracture (VCF) is when one or more bones of your vertebrae collapse. Vertebrae are round, strong bones stacked on one another. Thirty-three of these bones make up your spine. Your spine goes down the middle of your back. Compression fractures of the spine happen when there is too much pressure on the vertebra. These fractures may be caused by injuries or diseases of the spine, and osteoporosis (weak bones). Older age, certain medicines, and having low bone mineral density may increase your risk for VCF. Eating a diet low in calcium and vitamin D, smoking, and drinking alcohol also increases your risk. These fractures happen most often in the thoracic (middle), and lumbar (lower) parts of your spine.
- You may have sudden, severe, sharp back pain after an injury. You may have pain that gets worse when standing or walking, and goes away when you stop moving. Chronic (long-term) VCF can cause mild back pain, height loss, shortness of breath, and trouble climbing stairs. You may also get kyphosis (rounded back), or lordosis (abnormal back curve). You may need x-rays, magnetic resonance imaging (MRI), or computerized tomography (CT) scan to help find your VCF. Bed rest, pain medicine, and a back brace may be used to treat mild VCF. Using a heat pad or ice pack on your back, changing your diet, and getting exercise may help decrease your pain. If your pain does not go away, treatments such as vertebroplasty, kyphoplasty, or open surgery may be done. When a vertebral compression fracture is found and treated, your pain may decrease or go away.
Take your medicine as directed.
Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
Nonsteroidal anti-inflammatory (NSAID) medicine
may decrease swelling and pain or fever. This medicine can be bought with or without a doctor's order. This medicine can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your primary healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow the directions on it before using this medicine.
You may need medicine to take away or decrease pain.
- Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.
- Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.
- Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.
Ask for information about where and when to go for follow-up visits:
For continuing care, treatments, or home services, ask for more information.
- You may need to return for x-rays, or other tests including bone mineral density.
Using heat and ice:
- Heat may be used to decrease pain and stiffness. Use a hot water bottle, heating pad, or warm, moist compress. To make a compress, dip a clean washcloth in warm water. Wring out the extra water, and put it on your back for 15 to 20 minutes, 3 to 4 times each day.
- Put crushed ice in a plastic bag and cover it with a towel. Put this on your back for 20 minutes three times a day. Ice makes blood vessels constrict (get small) which helps decrease inflammation (swelling, pain, and redness). Do not sleep on the ice pack. It may help to have someone rub the ice on your back.
- Avoid activities that may make the pain worse, such as picking up heavy things. When the pain decreases, begin normal, slow movements as directed by your caregiver. Your caregiver may have you do weight-bearing exercises such as walking. You may also do non-weight-bearing exercises such as swimming, and bicycling.
- Use a walker or cane when walking. Ask your caregiver for more information about how to use a cane or a walker.
- Do not smoke cigarettes, cigars, and pipes. For women, smoking increases your chance of early menopause, and lowering estrogen, which increases your risk of osteoporosis.
Occupational therapy (OT) uses work, self-care, and other normal daily activities to help you function better in your daily life. OT helps you develop skills to improve your ability to bathe, dress, cook, eat, and drive. You may learn to use special tools to help you with your daily activities. You may also learn new ways to keep your home or workplace safe.
You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.
- When picking things up, bend at the hips and knees. Never bend from the waist only. Use bent knees and your leg muscles, not your back as you lift the object. While lifting the object, keep it close to your chest. Try not to twist or lift anything above your waist.
- Keep your home safe. Have enough light so you can clearly see everything. Leave a light on at night to help you find your way to the bathroom and kitchen. Have carpet placed in the bathroom instead of hard flooring. Hard flooring becomes slippery if it gets wet. Secure carpeting to the floor around all edges. Remove throw rugs, or secure them with double-sided tape, or special backing. Wear shoes with rubber bottoms to prevent falls. Ask your caregiver for more information on how to prevent falls in your home.
Managing pain at night:
- Sleep on a firm mattress. You may also put a one-half to one inch piece of plywood between the mattress and box spring.
- Do not use a waterbed. These beds do not support your back well.
- Sleep on your back with a pillow under your knees to decrease pressure on your back. You may also sleep on your side with one or both of your knees bent, and a pillow between them. You may also try lying on your stomach with a pillow under you at waist level.
- Avoid drinking too much alcohol. Alcohol is found in beer, wine, liquor such as vodka and whiskey, or other adult drinks. Drinking alcohol can increase your risk of getting osteoporosis. Talk to your caregiver if you drink alcohol.
- Eat foods that are high in calcium and vitamin D, such as milk, cheese, yogurt, salmon, tofu, almonds, and beans. This will help keep your bones strong, and decrease bone loss.
- Stay at the weight suggested by your caregiver. Weighing too much increases your risk of back injury.
CONTACT A CAREGIVER IF:
- You are not hungry, and you are losing weight.
- You cannot sleep or rest because of back pain.
- You have pain or swelling in your back that is getting worse, or does not go away.
- You have chest pain or trouble breathing that is getting worse over time.
- You have questions or concerns about your fracture, medicine, or care.
- You see that you are getting shorter over time.
SEEK CARE IMMEDIATELY IF:
- You have new problems passing urine, or having bowel movements.
- You have new and severe pain in your back after falling, bending forward, sneezing, or coughing.
- You suddenly cannot feel your legs.
- You suddenly have a very bad headache or a seizure (convulsion).
- You suddenly have trouble moving your arms or legs.
- You suddenly feel lightheaded and have trouble breathing.
- You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.