PERSONAL-EXPERIENCE IN MANAGING ACUTE COMPRESSION FRACTURES, THEIR AFTERMATH, AND THE BONE PAIN SYNDROME, IN OSTEOPOROSIS

Recovery from acute symptomatic vertebral compression fractures in ost eoporosis patients can be said to occur in three broad stages. For ove r three decades the author managed them in the following way. In the 3 -week-long acute stage after the fracture, the patient usually stayed in bed for 4-8 days until able to turn easily from side to side. Then a back support was provided and the patient was allowed up for frequen t but brief intervals. In the following approximately 10-week-long hea ling stage, the patient lay down for 20 min every 2 h (the Intermitten t Horizontal Rest Regimen or IHRR). Patients who developed a subsequen t lordotic low back pain stage did the IHRR for a further 10 weeks. In the uncommon bone pain syndrome, doing the IHRR for 10 weeks, or occa sionally longer, also relieved pain. When the IHRR failed to provide e arly pain relief in a compliant patient, other causes of the pain were sought and were usually found.