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 ma y be biconcave, anterior wedge, or crush deformities. A fracture is mo st often precipitated by putting a load on outstretched arms (eg, whil e raising a window). Bach pain is usually incapacitating for a few wee ks, then diminishes in severity but remains intense for 2 to 3 months. Acute complications include transient ileus, urinary retention, or (r arefy) cord compression Long-term effects include kyphosis, deconditio ning, insomnia, and depression. Initial treatment includes bed rest, p ain, 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 osteoporos is with calcitonin or estrogen in selected patients.