Slips and falls in the rain and snow are a major cause of painful traumas, especially in older people this time of year. The worse type of injury is the vertebral fracture. This occurs when a hard fall onto the back or buttock causes one or more of the bones of the spine to fracture and collapse. The fracture is extremely painful because unlike other fractures, it’s position deep in the body prevents it from being immobilized to allow healing and even everyday activities such as sitting up to eat a meal causes movement of the fractured bone.
If you experience a fall and have severe pain that doesn’t improve within one to two weeks and have severe back pain with any position or activity except lying down, more than likely, you have a spinal fracture. It is very important to have a physician evaluate you and order a diagnostic x-ray so that you can receive appropriate treatment in a timely manner.
The treatment for a spinal fracture depends on the severity of pain and on how much the pain limits your everyday activities. Younger adults may have a fracture, but because of good muscle tone and strength surrounding the spine, they might not have such severe pain that prevents their usual activites such as work, dressing, bathing, eating, etc. Older adults however, tend to have less muscle mass and support of the spine so that even sitting at the dinner table to eat a meal is a chore because of severe pain. In less painful fractures, wearing a tight, elastic, low back support belt can be very helpful, along with taking anti-inflammatory medications such as Advil or Aleve. These fractures may take up to six months to a year to heal naturally.
For older adults who have severe pain that prevents them from participating in their usual activities of daily living, we recommend a curative procedure called a Percutaneous Balloon Kyphoplasty. The procedure fixes the fracture by injecting cement into the bone through a thin, hollow needle. The cement is the same that is used in knee and hip replacement surgeries. It hardens immediately and the severe pain is gone immediately as well. The procedure is safe, done in the office under conscious sedation and takes one to two hours. There are no physical restrictions after the procedure and since the fracture is then fixed, there is no need for any strong pain medications.
I recommend that the procedure be done as soon as the fracture is identified if there is severe pain. If the fracture is allowed to heal on its own, it will likely heal with a deformity of the bone that causes the spine to bend forward, called kyphosis. Kyphosis can lead to long term health problems including respiratory diseases and chronic back pain. An MRI of the spine is usually ordered by the doctor to ensure that the fracture is still new enough to be fixed. Usually the MRI will show inflammation of the bone due to the fracture even six months after the fall has occurred. Once the bone heals, usually six months to a year after the fall, nothing can be done to reverse the deformity.
The best option of course is to avoid falls and injuries. “An ounce of prevention is worth a pound of cure,” as our friend, Benjamin Franklin, says. Wear shoes with good treading and if you need a cane or a walker, use it! Do as much safe exercise as you can to keep your back and spine strong and healthy.