A fracture in the spine occurs when the vertebrae or small bones that form the spine collapse or break. There are 5 different types of spinal fractures, but the most common type is the spinal compression fracture. A compression fracture occurs when the vertebrae collapse together. These fractures commonly occur in people with osteoporosis, women over the age of 50 who are postmenopausal, or any individuals over the age of 60 who may have weakened bones.  Our expert physical therapists at Progressive Physical Therapy help patients with spinal compression fractures reduce their pain and improve their strength, flexibility, and overall function.

What is a compression spinal fracture? 

Approximately 700,000 cases of spinal compression fractures per year occur in the United States due to osteoporosis. It is estimated that 25% of women who are postmenopausal in the United States have had a vertebral compression fracture due to weakening of the bones from changes in hormones that occurred during this period of their lives

When the spinal bones are weakened, a simple activity, such as bending to lift an object, twisting, or even coughing, laughing, or sneezing can cause a spinal compression fracture. These small compression fractures can gradually cause the spine to become shorter and less stable, and can weaken the entire spine. Generally the compression fractures cause the bone to break down in the front (anterior) portion of a vertebra, while the back (posterior) portion of the vertebra remains solid. This frontal breakdown causes the spine to round forward, which is called a Dowagers Hump or thoracic kyphosis.

A spinal compression fracture may also be caused by trauma to the spine, such as a car accident, hard fall, or blow to the head. Physical therapy begins after the compression fracture has been deemed “stable,” which can take up to 8-10 weeks. Our physical therapists are trained to help people with spinal compression fractures reduce their back pain and improve their flexibility, strength, and overall function, and restore the activity levels they had prior to the injury. Physical therapy will also help patients reduce falls risk that can lead to future fractures.

How can a physical therapist help?

Your physical therapist will perform a complete evaluation, including your past medical history, any medications you may be taking, and your current symptoms. Your regular activities of daily living will be discussed so your physical therapist can design a treatment plan specific to your personal needs and goals.

Your physical therapist will perform a physical examination of your spine. The therapist will touch areas of your spine to determine any pain or tenderness of the spinal areas involved. Your spinal movements (range of motion) will be assessed in your neck (cervical spine), middle back (thoracic spine), and lower back (lumbar spine). Your physical therapist will also measure the strength in your spine, legs, and shoulders. Balance testing will be performed to determine if you are at risk for falls that can lead to other fractures.

Surgery is rarely needed in cases of compression fracture. It may take 8 to 10 weeks after your diagnosis for the spinal compression fracture to heal. During the healing process, you may take pain medication and medications to improve your bone density, as determined by your physician. Your physician may choose to have you wear a back brace for extra support. Braces are used with caution, as they can contribute to muscle weakness. You will also need to reduce your overall activity level during this time to allow the bones to heal. This means no heavy lifting, bending, or twisting activities, and may require a short period of bed rest, depending on the severity of the fracture.

After your spinal fracture is healed and it is considered safe to increase your activity level without risk of reinjuring the bone, you may see a physical therapist for an evaluation to begin treatment. During the healing process when your mobility is limited, muscles in the core, hips, and back can become weakened. This weakness can make it difficult to resume your regular activities, and the weakness can put you at greater risk for falls.

Your physical therapist can help you regain the strength and mobility that you may have lost while the fracture healed. Your treatment plan may include:

Pain Management. In the initial recovery phase, the goal of physical therapy will be to reduce any pain and inflammation in the affected area. Manual therapy, including soft tissue mobilizations and gentle massage, may help manage your pain as well as the application of ice and electrical stimulation. After the fracture has healed, moist heat can help decrease pain due to muscle spasms in the spinal region.

Flexibility Exercises. You may learn and perform gentle spinal range-of-motion exercises for the neck, thoracic, lumbar, hip, and shoulder areas.

Strengthening Exercises. Bones strengthen when forces are applied to them. Your physical therapist will prescribe gentle weight-bearing exercises to help stimulate your bone strength. Upper- and lower-body as well as abdominal and back muscle-strengthening activities will be performed, including the use of light weights.

Posture and Movement Education. Your physical therapist will teach you how to maintain safe postures and spinal positions to protect the vertebrae from undue stress. For instance, you will learn safe positions for sleeping, sitting, and standing. You will also learn proper body mechanics for performing tasks at home, such as bending and lifting. Your physical therapist will also design an individualized home-exercise program, which you can continue after you have completed your physical therapy program.

Fall Prevention. Your physical therapist will teach you exercises to improve your balance and steady your walking gait to prevent falls. You may perform gentle exercises on a variety of surfaces. You will also learn ways to modify your home environment to make it safer and reduce the risk of a fall.

Referral to a Nutritionist. You may be referred to a nutritionist for a consultation. Getting the proper nutrients from your diet can help improve bone growth and strength

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