Osteoporosis: Your Back Pain May Be Caused by a Hidden Spinal Fracture

Article submitted by Bruce Putnoky of ACCUCARE Interventional Pain Medicine.
For more information, he can be reached at 866-322-6500.

We are becoming increasingly aware of the dangers of osteoporosis in later life. The American public generally now knows that the bones within our skeletal system can become thin, brittle and weak with age. What most people don't know is that osteoporosis can also occur in people as young as 40 years old. Although the incidence is far more common in post-menopausal women, approximately 20% of the 750,000 or so cases reported each year occur in men. The insidious aspect of osteoporosis is that because of the "silent" nature of this disease there are typically no symptoms displayed until that first fracture occurs. More often than not, that first fracture can occur in the delicate vertebra of the thoracic spine. This type of fracture is commonly known as a "crush fracture" or spinal compression fracture. The staggering fact is that the problem is commonly overlooked and wrongly attributed to the expected "aches and pains" that come with the aging process or to the general category of back pain from "muscle strain". Because of this unnecessary acceptance of back pain by the patient, a full two-thirds or 500,000 cases of compression fracture of the spine each year are not diagnosed and therefore left untreated.

In severe cases of osteoporosis, compression fractures of the vertebra often occur while performing the functions of daily life. Lifting, coughing or sneezing, have been known to cause vertebral fracture in advanced cases. Routine activities that would normally not cause spinal trauma such as opening a window or even turning over in bed can become problematic. Severe trauma as experienced in a car accident or a hard fall will provide a higher likelihood of nerve injury to the osteoporotic spine. The spinal canal contains the spinal cord and its delicate neurological structures. If the vertebral fracture compromises the spinal canal and places pressure on the spinal cord, the patient will be likely to experience impairment of spinal cord function. Depending upon the severity, the patient may display a variety of symptoms ranging from a mild loss of strength, sensation or reflex. Unfortunately, in extreme cases, the patient may experience full or partial paralysis below the level of spinal cord injury.

Fortunately most compression fractures collapse the front of the spinal vertebra, leaving the bone surrounding the spinal canal intact. This results in a wedge shaped vertebral body that physically alters the mechanics of the spine and can force cosmetic changes to the patient's appearance. These fractures are usually followed by acute back pain; and, left untreated, may lead to a number of chronic problems. Thoracic kyphosis, a spinal deformity commonly known as dowager's hump (stooped posture), is a result of compression fractures of the spine. Patients may also experience loss of height, crowding of internal organs, and loss of muscle strength and aerobic conditioning due to the subsequent lack of activity. The lack of mobility can open the door to various disorders that range from pneumonia and pulmonary embolism to blood clots in the lower extremities.

The pain and many of the complications associated with vertebral compression fracture are most likely to be averted with early medical intervention. The primary focus of this editorial is to inform the person experiencing back pain for longer than eight weeks (the threshold of pain advancing to the chronic stage) to seek medical assistance from a qualified interventional pain specialist. An advanced Interventional Pain Medicine physician will rapidly address the back pain problem by locating the exact pain generator and immediately treating it so that the pain does not become chronic. If the pain problem is being caused by a vertebral compression fracture, the Interventional Pain Physician will be immediately able to diagnose and treat the fracture, without surgery, to prevent the patient from any future complication. The most current technology available for the treatment of compression fracture and metastatic bone cancer is a procedure known as vertebroplasty. This very safe and highly successful outpatient procedure stabilizes the collapsed vertebra with the injection of medical grade bone cement directly into the fracture. This relieves the pain almost immediately and prevents further collapse of the vertebra. Early detection and rapid intervention by an advanced Pain Medicine Specialist may prevent a lifetime of pain for the patient with osteoporosis.