Vertebral compression fractures: how to manage pain, avoid disability.
About 25% of U.S. women over age 50 will suffer one or more vertebral compression fractures related to osteoporosis. Vertebral fractures may be biconcave, anterior wedge, or crush deformities. A fracture is most often precipitated by putting a load on outstretched arms (eg, while raising a window). Back pain is usually incapacitating for a few weeks, then diminishes in severity but remains intense for 2 to 3 months. Acute complications include transient ileus, urinary retention, or (rarely) cord compression. Long-term effects include kyphosis, deconditioning, insomnia, and depression. Initial treatment includes bed rest, pain management with local and systemic analgesia, bracing to improve comfort, and patient reassurance. Long-term management includes spinal stretching exercises, walking, and treatment of underlying osteoporosis with calcitonin or estrogen in selected patients.
Lukert
B P
BP
Department of Medicine, University of Kansas Medical Center, Kansas City.
D000208:Acute Disease; D000368:Aged; D005260:Female; D017102:Fracture Healing; D005598:Fractures, Spontaneous / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000628:therapy; D010146:Pain / Q000209:etiology; D059408:Pain Management; D016103:Spinal Fractures / Q000150:complications / Q000175:diagnosis / Q000628:therapy*