About 700,000 Americans will develop fracture of their spine each year. This causes great pain and discomfort. This blog will define the problem of broken back and what can be done to help you return to normal activities.
What is a broken back really?
The spine is made up of strong bones called vertebrae. They make up the spine column and help support the spinal cord or the nerves that connect the brain to muscles and bones. These vertebral bones can break or fracture just like any other bone in the body. When they break, the bone collapses and it is called a vertebral compression fracture. Vertebral compression fractures are overwhelming caused by osteoporosis or softening of the bones.
Osteoporosis is a disease of the bones that causes them to become more fragile. As a result, the weakened bones may not be able to withstand normal stresses on the body. They may break from a minor fall, from a simple action such as taking the first step onto out bed in the morning or from with a fit of sneezing.
The broken bones with osteoporosis can occur anywhere in the body but are most likely to occur at the hip, spine and wrist.
A broken bone in the spine can be very painful. When they collapse, it affects posture and you become hunched or bent over. In addition to the obvious pain, the bone collapse can lead to deformity and disability. It can lead to difficulty taking deep breaths and as a result of poor breathing this puts you at increased risk for pneumonia. Studies have even shown there is an increase risk of death in people with vertebral compression fractures.
Symptoms of a spinal bone fracture
Approximately 1.5 million people suffer from a bone fracture from osteoporosis each year. Nearly half those people experience a spinal fracture. Symptoms of vertebral compression fracture include;
- Sudden onset of back pain
- Pain made worse with standing or walking
- Pain that may improve with laying flat
- Limited spinal mobility
Diagnosis of a spinal bone fracture
The problem with a bone fracture in the spine is that is not always recognized. Sometimes people mistake the new back pain as a muscle strain, as spinal arthritis, or worse – as just a common part of aging. When this happens, the patient is not checked for a vertebral fracture and does not receive the treatment they need.
As a general rule a spinal compression fracture should be suspected in anyone over the age of 50 with new back pain. This is especially the case for women as they are at a greater risk for osteoporosis. If you have a new onset of back pain go see your doctor. The broken bone is diagnosed by taking a complete history and physical examination. He or she may order an X-ray or an MRI of the spine to show where the bones are broken.
Do you need back surgery for a compression fracture?
Spine surgery is a serious undertaking. Because the surgery takes place near the spinal cord there are significant risks and the surgery is reserved as a last option. It may be necessary to have surgery however, if the fracture causes instability of the spine, if the bone fracture causes pressure on the spinal cord or spinal nerves, or if there are bone fragments that need to be removed. Surgery usually includes some type of fixation inside the body to hold the bones of the spine in their proper position.
Alternatives to surgery
Thankfully surgery for vertebra compression fractures in the spine is rarely needed as there are more conservative treatments available. Treatments include;
- Decreasing activity – Avoid lifting heavy objects or any activity that puts too much strain on the spine.
- Pain medicines – Mild pain medicines may help to mask the pain to allow time for the body to heal
- Bracing – A brace supports the back and restricts movement. It helps to protect the vertebra and may limit further collapse.
- Minimally invasive procedures – newer non-surgical procedures called vertebroplasty and kyphoplasty or sometime vertebral body augmentation. These procedures are designed to immediately stabilize the vertebral fracture to treat the patient’s pain almost instantly and prevent worsening spinal deformity. Vertebroplasy and kyphoplasty procedures can help patients avoid the need for surgery.
It happened once, it can happen again.
A spine fracture is often due to osteoporosis. Treating a broken bone by itself helps with pain and disabling symptoms but we must remember also to treat the underlying cause of osteoporosis to prevent more fractures from occurring.
Treatment for osteoporosis includes education on nutrition, increased exercise and medications to help maintain bone density. There are several types of medicines to treat osteoporosis and therefore help reduce the risk of fractures. These medications work by strengthening the bone either by slowing bones from breaking down or by increasing bone formation.
Keeps your bones strong through good diet and regular exercise. If you have a vertebral compression fracture look to alternatives to surgery such as short-term pain medicines, back brace or minimally invasive vertebroplasty and kyphoplasty procedures before considering back surgery. You should only consider back surgery if you have tried all the other conservative options first. If you do have a compression fracture due to osteoporosis, take steps to limit if from occurring again by taking medicines that strengthen the bones.