Brendas vertebral compression fractures changed her lifestyle. Often your physician is a generalist. She is fastidious about her chart and can see her progress. The illustration shows the normal curves in our spine. The first photograph on shows a flexion exercise. My question is are there other people who have cerebral palsy having Prolia injections and if so what are the implications for people unable to exercise? In the video below you will meet Brenda one of my clients with compression fractures and hear her story of how her compression fractures happened, how they affectedher quality of life, and what she has done to return to living an active life. Many thanks and my sincerest appreciation in advance for your help! Due to the Personal Health Information Protection Act of Ontario, I do not use a public forum to discuss individual situations. Sometimes she will put her purse in her back and adjust it so it is in the small of her back. Its helped tremendously. However, you should take a look at how your bone mineral density (BMD) scores have been changing over the last decade. Will it help or make it worse? The most significant risk factor for obtaining a vertebral compression fracture is having osteoporosis. (1) They are generally classified when at least 20% of the height of the affected portion is lost. [2] The use of a spinal orthosis maintains neutral spinal alignment and limits flexion, thus reducing axial loading on the fractured vertebra. 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. Dr, does not take Medicare but files with them,Medicare denied payment because too much time had elapsed between between the two shots should be no more than 166 days and I had180days! I could not sit around even if I wanted to I had to keep moving so my back was not cramping and seizing up. Have open and honest conversations about these feelings with your partner. Had 2 xrays one neck and one middle back nothing showed a but if small degenerative change in my neck. Her mom had fractured both of her hips as well as her pelvis. The recovery time after surgery, on the other hand, can be much longer. Would you be kind enough to tell me what stretches I can do safely in the meantime. 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. . She was diagnosed with osteopenia. I am very grateful for this site and especially the exchange between Deborah and Margaret. Thank you. VCFs most often occur in the thoracic (middle) and lumbar (lower) areas of your spine. Basic equipment is required and is outlined in the DVD. Brenda has had to embrace the crumpled look because everything hurts around her middle. Learn how your comment data is processed. If you are at risk of a compression fracture, already have one or know someone suffering from a compression fracture, you should read this blog post and view the videos the time you invest will be well worth your while. Exhaling thru pursed lips as he visualizes drawing up the big boys as they would say in Australia. She can do it with the poles and the vest because it keeps her in the proper position. It depends on your body, how strong you were, the quality of your bone, and your form when you exercise. 93% of the men who had their fractures diagnosed during the study reported back pain. Compression Fracture Physical Therapy & Lumbar Exercises How to Treat a Compression Fracture Share Watch on Can You Exercise After Compression Fractures? Hi Margaret, Thank you for all the helpful information on osteoporosis. It is recommended to wear the brace/orthosis for 6 to 12 weeks, followed by supervised physical therapy. All of those exercises are incredibly safe and progressive. 3 lbs and resting between the lower third of the shoulder blades. She does not have that same pulling forward sensation that she experienced before. Ensure that your MD gives you the green light. Brenda is limited in what she can do in the kitchen. Core strength and osteoporosis why is core strength important if you have osteoporosis? I think it is very important to have a physical therapist who specializes in PT for osteoporotic patients. But it is relieving to see that people are finding ways to go on. I do not SPAM or share your email address (or any information) with third parties. I would have preferred one with the information you have provided about getting in and out of bed, what to avoid doing, posture etc. When its not there, she can really feel the difference. Other activities that may require you to bend or twist forcefully at the waist are golf, tennis, bowling and some yoga poses. People who have severe osteoporosis can fracture a bone during daily activities. While sitting, hold an exercise band out in front with arms extended. 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. In the beginning, shortly after the compression fracture food preparation was limited to semi-prepared or prepared foods. The physiotherapist (the one she saw before she came to see me) helped with the pain. The pain is axial, non-radiating, aching, or stabbing in quality and may be severe and disabling. For the last 15 years, she has concentrated on bone health and has treated thousands of patients for their osteoporosis, osteopenia and low bone density. Certain medications: eg oral steroids, anti-depressants, diabetes drugs. It turned out that Brenda came to this conclusion prematurely. I live in Winnipeg and would like to know if you know of a good dr or physio therapist that deals with compression fractures? The DVD is great if you fall into the Beginner / Active category in the book and you would prefer to follow along with a daily 30 minute program rather than do it on your own. I can so relate to all the aspects of pain and limited movement although I wasnt quite as bad as above. There are four subtypes for compression fractures. I cover important topics related to osteoporosis exercise including: Enter your email address and I will start you on this free course. A compression fracture of the lumbar spine is also known as a wedge fracture. I went through 6 weeks of physical therapy, but I still have pain. Compression fractures happen when there is too much pressure on the vertebra. She felt despair and anger because of her compression fractures. I just fractured my fifth thoracic vertebrae from severe osteoporosis. Are there any studies done with that scenario? Desperate to know what really is causing all this and how I can best help myself. I want to talk about a topic that is especially close to my heart: movements that increase your risk for spinal fractures or compression fractures. I still suffer pain and discomfort. A crush vertebral compression fracture is the least common type of vertebral compression fracture. It may be ankle pumps or butt squeezes. Everyone is different and the exercises will need to be broken into groups and delivered at apace that works for you. So I guess my question besides the video should I begin now with meds or just continue eating well and up my strengthening and wait til I break a bone? Fracture risk increases with age, with four in 10 white women older than 50 years experiencing a hip, spine, or vertebral fracture in their lifetime. I compression fractured my L4 7 days ago. Brenda says you should not be afraid to get a second opinion. It is so very important to remind yourself that this can happen. The bending is happening in the knee and hip as opposed to the spine. All the neurosurgeons and spine specialists do not have any advice for me. She has not had to use a walker for about the last three weeks. You have to be your own calcium conscience. But all is not lost. Similarly to Jeri Ettleson, most of my pain is on the right side, but at the back, through the rib area. Due to an underlying health condition, I was placed on high dose prednisone steroids, that in just 2 years time, weakened my bones so severely, that I have encountered SEVEN vertebral compression fractures in the last 5 months. I also prepared a video explaining flexion and extension. Although a vertebral kyphoplasty can give you pain relief, it doesnt actually stop the progression of further compression fractures. If you are a side sleeper, make your head pillow wide enough that it supports your head in a neutral position (i.e. Have you ever heard of this type of pain? Gertzbein SD, Khoury D, Bullington A, St John TA, Larson AI. I have seen countless specialists for these fractures, all of whom say theyve never seen such, and in turn are at a loss on how to advise any sort of short or long term treatment plan. It increases the trunk muscle strength in patients with osteoporotic fractures in the vertebrae. I asked Brenda to discuss the treatment she received after the diagnosis of her compression fractures. There is a risk of neurological damage, when this is the case, surgery is recommended,[10] Neurologic deficits are quite uncommon. After you provide your email address, you will receive seven consecutive online educational videos on bone health one lesson each day. Print. Unfortunately, this exercise is still very popular in exercise classes and used by many personal trainers. I find that many of my clients do not have enough protein in their diet. But all that changed 100% because of the pain. Rather, it is meant to inform you that it is in your control to help yourself reduce the further risk of a compression fracture. As for the weighted kypho-orthosis the company that was making them is no longer but you can try using a little backpack purse. Hi Karen, thank you for sharing your story. Tapering the steroids will help. Have a greater mobility in flexion and extension. Diagnosis and management of vertebral compression fractures. I am 60 years old. Is there a best way to sleep with a compression fracture? They had an easier outcome of doing their tasks of daily living, their functional mobility was improved and their balance was improved. Exercise for Better Bones is an osteoporosis exercise program that provides exercise programs for people at different fracture risk and activity levels. If you are a woman, especially if you are post . Avoid sleeping in a recliner. Thanks! Normally vertebroplasties and kyphoplasties are only within 6 weeks of the compression occurring. Osteoporos Int. Once your muscles have started adapting to the change in height caused by the spinal compression fracture and the compression fracture has had time to heal (usually 8 to 12 weeks after the episode of increased pain) you should start a compression fracture exercise program. A compression fracture is a type of fracture or break in your vertebrae (the bones that make up your spine). I have created a page of Recommended Products you can consult. There are two more videos later in the blog. Vertebral compression fractures (VCF) may alter your sex life, but they should certainly not eliminate it. If your diet and exercise pattern has remained constant and your BMD has been staying fairly constant then you know you are on the right track. Build up gradually and stay as strong as you can. Further, unless we counteract that with some extension exercise, as you see in group #3 where they did some extension and some flexion, you will not reduce your rate of compression fracture. This movement could cause a compression fracture. If you do not have the flexibility in your hips to do so you can get get a sock helper. A simple yet effective stretching exercise for the lumbar spine is to sit on the floor, legs outstretched in front of you. I got your book from library and love it. She has been interviewed as an expert in osteoporosis prevention and treatment by WebMD, the Toronto Star, CTV Ottawa Morning Live, the Senior Rehab Project podcast, and Dr. Rebecca Risk's podcast, Falling Through the Cracks. I too have been very mindful of bone strength and my genetic vulnerability way before menopause. 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. Osteoporosis: diagnosis and management. Symptoms of a compression fracture of L1 include pain in the lower back or buttocks, numbness in the legs, and difficulty walking. I am finally starting to feel better. It is not so much as a support, as a reminder: Dont do bad moves. (Brenda uses the Obusforme Brace in the illustration.). I wish I had the opportunity of working one on one with you. Make sure you follow good movement patterns during your activities of daily living (ADL). Fractures can weaken the entire spine. You can use one for the garden for picking up things like sticks. They also taught me about how to pick things up, laying in bed, etc. The last type of compression fracture is classified as complex. My clients who regularly do their exercises feel stronger and have less pain. This presentation, created by Mel Kaplan, Jacob Landersm Kari Mann, and Kelsie Martin; Texas State DPT Class. I decide the appropriate mix of postural and flexibility exercises based on my assessment of the individual. Their pain returns, some experience another vertebral fracture. . Also, do not assume that your physio understands osteoporosis be sure to ask what training or postgraduate courses they have taken in the area. I hope that this blog does help make the life of listeners a little bit easier out there, and if anybody wants to add their comments at the end the blog, feel free to do so. Physical examination findings are often normal, but can demonstrate kyphosis and midline spine tenderness. My suggestion is to use them appropriately for tasks that you actually need that extra support such as when you work in your garden. Place the blanket lengthways. Within the book, Exercise for Better Bones, you will find a link to over 30 + suggestions on daily activity modifications that you should consider. Start small. Promote your recovery from spinal compression with physical therapy. In addition, the brace allows for less fatigue of the paraspinal musculature and muscle spasm relief. Let your partner know how you feel and discuss the support you need. A routine DEXA (Dual-Energy X-ray Absorptiometry) test and FRAX score, in 2011, showed that Brenda had some bone loss. Doing some gentle exercises helps to improve muscle tone, ease tension and reduce muscle spasms in your back. Martin Dunitz, 1998, Sujoy M, Yu-Po, L. Current concepts in the management of vertebral compression fractures. The white vertebra is compressed. Stretching helps promote healing of injured bone, ligaments and tissues and may help relieve pain in the lower back caused by a compression fracture or following surgery. She is putting a lot of force on her spine, especially in her mid back, through this position. We have a normal small outer curve in our upper back, referred to as the thoracic spine. Thank you very much for posting. He is lucky to have you as a therapist. Margaret. My heatpad is one of the most important things in my life at the moment. Margaret is unable to answer your question without a proper assessment. Dont disregard back pain that only lasts a couple of weeks. Your pain should get better with time. Four months is still early days. They likened the healing to when a knuckle has a skin crack and if you keep bending it that it takes longer to heal. Then they become fearful of moving and its a vicious circle. In 1984, Dr. Mehrsheed Sinaki at the Mayo Clinic did a study (5) on postmenopausal osteoporotic women that looked at the effects of flexion exercises versus extension exercises. It helps take the ache away. Follow your physical therapist and doctor's instructions regarding resumption of any type of exercise following a compression fracture. Margaret Martin is a Physical Therapist with 36 years of clinical experience. These conversations provide you both with the opportunity to demonstrate love and care for each other. They relieve her pain or her aches. I have had the impression that now I have this disability I just have to live with it! Avoid a memory foam mattress if you keep your room cooler than 65 degrees Fahrenheit at night (because they get too stiff). 13 It is . Keep your elbows by your side. Here are Brendas thoughts on that question. Hi Johanna, So glad that Brendas story was helpful to you. Margaret. The most common cause of this type of fracture is a fall from a height, but it can also be caused by a car accident or other trauma. She wears her compression fracture brace to remind her what not to do. Thank you for your kind comments. Osteoporotic patients might have a loss of height. 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. The thought behind that is that for a lot of things that we do in life such as picking out the laundry, reaching forward, coughing, sneezing, involves a lot of flexion. Complications include extravasation of cement (more common with vertebroplasty), embolism, neurologic injury, bleeding, hematoma, infection, and an increased risk of VCFs at other levels[14]. Once you have been given the green light by your physician or surgeon to exercise, you can also start exploring intercourse again. [Epub ahead of print], Kim L Bennell, Bernadette Matthews, Alison Greig, Andrew Briggs, Anne Keppy, Margaret Sherburn, Judy Larsen, John Wark. Brenda concluded that her bones were healthy because of her exercises, diet and Prolia injections. 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. In White AA, Panjabi MM, eds: Clinical Biomechanics of the Spine, 1990, Bogduk N. Clinical anatomy of the lumbar spine and sacrum. If you understand intellectually what the exercise will do, then she really motivated in terms of her everyday life. It helps take the ache away. She could not lift a dish in or out of the oven. What exercises build bone and which ones reduce your chance of a fracture? I am also going through the decision of what to do re pharmaceuticals have not taken anything yet. I would appreciate your comments. [5]. The x-ray image of the spine below shows a compression fracture. In both cases, your surgeon injects a type of medical cement into your damaged spine to heal the fracture. Can lead to multiple anterior wedge fractures: increased thoracic convexity. Top Contributors - Remko De Smedt,Ivakhnov Sergei, Andreas De Feyter, Lucinda hampton, Kim Jackson, Lien Hennebel, Lauren Lopez, Rachael Lowe, Sam Verhelpen, WikiSysop, Alexander Ghyssels, Joshua Samuel and Aminat Abolade. And is there a method for tying my shoes? She was able to manage the pain because she had some over-the-counter pain medication with her. Compression fractures happen when there is too much pressure on the vertebra. The second photo shows an extension exercise. You know your own body, and that is important to follow through. Is there any way to forward my email to Brenda? 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. Be sure you communicate openly with your physio so that she/she can ensure that all the exercises you do do not increase our pain. Visual analogue scale for overall pain (VAS), The Patient-Specific Functional Scale (PSFS), Quebec Back Pain Disability Questionnaire, Nonsteroidal anti-inflammatory drugs (NSAIDs), https://radiopaedia.org/articles/osteoporotic-spinal-compression-fracture, https://www.youtube.com/watch?v=LILgFAEMAbg. That is usually the journal article where the information was first stated. It is invaluable. No one with low bone density should be manipulated as the forces can cause a (another) spinal fracture. Hold your stretches for 30 seconds and then relax. For further information, please read my blog on orthotic braces. Fractures may be mild to severe. A compression fracture of L1 is a break in the vertebrae, which is the bone that makes up the spine. We know from previous tutorials that the vertebral body is composed of a hard outer coating. Many thanks again. It was almost like reading about myself. This is really terrible because it affects their quality of life.