What should I expect as I recover?
Most spinal compression fractures caused by osteoporosis get better within approximately eight weeks. As mentioned, most patients who suffer compression fractures from osteoporosis don't require surgery. Instead they are treated conservatively with rest, bracing and a few rehabilitation sessions early on for pain relief and education regarding self-management.
Rehabilitation after traumatic vertebral fractures, unfortunately, can be a much slower process. In these cases, patients sometimes need to attend therapy for two to three months and should expect full recovery to take up to one year.
Physiotherapy treatment for a spinal compression fracture at Parkway Physiotherapy usually begins once the fracture has been positively confirmed on investigation and has been determined to be stable. If a period of relative bed rest has been prescribed, physiotherapy will begin after this rest has been adhered to.
Your initial treatment at Parkway Physiotherapy will aim to decrease the inflammation and pain caused near the area of the compression fracture. Your physiotherapist may use electrical modalities such as ultrasound or interferential current to ease these symptoms. Massage to the muscles or other hands-on techniques such as gentle traction to the joints may also be helpful. Often applying ice or heat to the painful area can also drastically ease the symptoms.
Fortunately, with the assistance of rehabilitation, the back pain caused directly from the fracture generally improves as the fracture heals. However, the fracture changes the way the spine works, so it is not unusual for patients to have some lingering soreness in the muscles and joints near the fractured vertebra. If there is a significant amount of pain that remains ongoing your physiotherapist will recommend that you return to your doctor for further discussions on managing the pain through medications.
As the pain from the compression fracture begins to subside, your physiotherapist at Parkway Physiotherapy will begin to focus on improving any flexibility and strength deficits you may have developed from the period of decreased activity following the compression fracture.
Your physiotherapist will prescribe exercises for you to do in the clinic and also to be done as part of a home program. Exercises that improve the range of motion in your back, neck, shoulders as well as your hips may be prescribed. If your compression fracture was from osteoporosis, then the extension motion of your upper back (thoracic spine) will be of paramount importance. As mentioned above, wedge compression fractures of the thoracic spine from osteoporosis often lead to a flexed back posture. The risk of losing the ability to function in the upright extended position is high so maintaining this motion is crucial. Even the proper use of your shoulder joints will suffer if the spine loses extension therefore exercises may also be prescribed to maintain shoulder function. Neck range of motion can also be affected if the flexed posturing becomes severe thus range of motion exercises for the neck may also be required. Hip range of motion deficits will be addressed as normal hip range of motion allows the spine to move more freely and decreases the stress on the spinal joints. Patients with traumatic stress fractures don’t often present with the wedge shaped fractures and therefore the primary focus will be the recovery of all ranges of motion, not just thoracic extension.
In addition to range of motion exercises, your Parkway Physiotherapy physiotherapist will also prescribe strengthening exercises which focus on the deep abdominal muscles for overall support of the spine, as well as exercises to strengthen the back muscles which resist the forward bending of the spine. For patients with osteoporosis, it is important to include weight bearing exercise such as walking or stair climbing. Bone reacts to increase stress by producing more bone, which increases its overall strength. The added stress of simple weight bearing activities therefore works to encourage stronger bones. Your physiotherapist may also prescribe exercises for you using light weights for the same reason of encouraging the build up of overall bone strength.
At Parkway Physiotherapy we believe that education for our patients is of utmost importance therefore discussions on how to improve and maintain your posture will be a large focus of our treatment. Your physiotherapist will discuss proper body mechanics when moving in order to keep your back in safe positions and avoid extra strain near the fracture as you go about your work and daily activities. We will discuss positions you use when sitting, lying down, standing, and walking as well as safe body mechanics with lifting, carrying, pushing, and pulling. We will also educate patients with osteoporosis on the proper techniques for simple daily activities such as coughing or sneezing, which due to the forceful flexion involved, can result in another compression fracture in those with particularly frail bones. Falling can also easily result in fractures of osteoporotic bones so balance activities may be added to your home program to decrease the likelihood of a fall occurring. The goal of rehabilitation at Parkway Physiotherapy is for you is to improve your posture, body mechanics, strength, and flexibility so as to avoid future injuries.
Parkway Physiotherapy provides services for physiotherapy in Victoria, Westshore, Langford, Sooke.