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Vertebral Compression Fracture
WHAT YOU NEED TO KNOW:
A vertebral compression fracture (VCF) is a collapse or breakdown in a bone in your spine. Compression fractures happen when there is too much pressure on the vertebra. VCFs most often occur in the thoracic (middle) and lumbar (lower) areas of your spine. Fractures may be mild to severe.
Call your local emergency number (911 in the US) if:
- You feel lightheaded, short of breath, and have chest pain.
- You cough up blood.
- You suddenly cannot feel your legs.
- You suddenly have trouble moving your arms or legs.
Seek care immediately if:
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
- You have new problems urinating or having bowel movements.
- You have severe pain in your back after falling, bending forward, sneezing, or coughing strongly.
Call your doctor or orthopedist if:
- 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 questions or concerns about your condition or care.
You may need any of the following:
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask if NSAIDs are safe for you. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider.
- Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly. Do not use more than 4 grams (4,000 milligrams) total of acetaminophen in one day.
- Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
- Bisphosphonates and calcitonin may be recommended to help your bones get stronger. They can decrease the pain of a VCF caused by osteoporosis, and decrease your risk for another fracture.
- Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her 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.
Heat and ice:
- Apply ice on your back for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel before you apply it. Ice helps prevent tissue damage and decreases swelling and pain.
- Apply heat on your back for 20 to 30 minutes every 2 hours for as many days as directed. Heat helps decrease pain and muscle spasms.
- Avoid activities that may make the pain worse, such as picking up heavy objects. When the pain decreases, begin normal, slow movements as directed by your healthcare provider. Your healthcare provider may have you do weight-bearing exercises such as walking. You may also do non-weight-bearing exercises such as swimming and bicycling.
- You may need to use a walker or cane. Ask your healthcare provider for more information about how to use a cane or a walker.
- When you pick up objects, bend at the hips and knees. Never bend from the waist only. Use bent knees and your leg muscles as you lift the object. While you lift the object, keep it close to your chest. Try not to twist or lift anything above your waist.
Physical and occupational therapy:
Your healthcare provider may recommend you start or continue one or both types of therapy. A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain. An occupational therapist teaches you skills to help with your daily activities.
Manage pain during sleep:
- Do not sleep on a waterbed. Waterbeds do not provide good back support.
- Sleep on a firm mattress. You may also put a ½ to 1-inch piece of plywood between the mattress and box spring.
- Sleep on your back with a pillow under your knees. This will decrease pressure on your back. You may also sleep on your side with 1 or both of your knees bent and a pillow between them. It may also be helpful to sleep on your stomach with a pillow under you at waist level.
Follow up with your doctor or orthopedist as directed:
You may need to return for x-rays or other tests. Write down your questions so you remember to ask them during your visits.
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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.