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Integrated Pain Management

Conditions

Compression fractures

Compression Fractures refer to the collapse of vertebra. The fractures are due to weakening of the vertebra or trauma. The weakening is mostly experienced by individuals who are suffering from osteoporosis or osteogenesis imperfecta, infection, or lytic lesions resulting from primary or metastatic tumors.

Compression Fractures

In healthy people, this condition occurs as a result of extreme vertical shock such as when a pilot ejects from the plane on an ejection seat.

Symptoms

Compression fractures might occur suddenly and this can result in severe back pain. The pain experienced is in most cases in mid lower spine and will be felt in the front or in the sides of the spine.

The pain has been described by patients as being knife-like and sharp. This pain is in most cases disabling and may take a few weeks and sometimes months to go away.

When the compression fractures are caused by osteoporosis, the symptoms will not appear immediately. These fractures are discovered in some cases when the patient has x-rays done for a different reason.

With time, the following symptoms may appear:

> Loss of height with some patients losing as much as 6 inches

> Dowager’s hump which is a kyphosis or stooped-over posture 

> Back pain which starts gradually and gets bad when walking and not present when resting.

In rare cases, the hunched over posture can result in the cause of weakness, difficulty in walking, loss of bladder and bowel and tingling and numbing sensations.

Causes

Osteoorosis has been named as one of the major causes of compression fractures. Osteoporosis refers to an illness where the bones turn fragile as a result of lack of minerals such as calcium.

Other causes include trauma of the back, tumors that started in the spine like myeloma, tumors that started in the bone or from anywhere else and spread to the bone.

Multiple fractures can lead to kyphosis which is the hump-like curve of the spine leading to an altered posture that might result in further complications and pain.

Most people experience their first acute low back pain when they are between the age of 20 and 40 years old. This is the first reason why most people see a medical professional in adulthood.

In most case there are recurrent pain episodes and in more than 50% of the people, the following episodes are more painful than the first one. There are other problems that might emanate from low back pain.

People suffering from chronic low back pain might experience sleep problems such as disturbances during sleep, less sleep satisfaction, short sleep durations and a great amount of time required to fall asleep. A large number of people suffering from chronic LBP will also show anxiety or depression symptoms.

Services

Diagnosis

A medical practitioner will perform a physical examination which might show the tenderness on the affected bones and spinal bones, humpback or kyphosis. An x-ray will reveal at least one compressed vertebra which will be shorter than other vertebrae or shorter than it should be.

Other test might include bone density to evaluate the possibility of osteoporosis, and MRI or CT scan in situations where the cause of the fracture is suspected to be trauma or a tumor.

Treatment

Most compression fractures occur in older people with osteoporosis and the fractures do not result in the damage of the spinal cord. This condition is easily treated using calcium supplements and medicines to prevent further fractures. The pain is managed using pain medication or a simple bed rest.

Other treatment options might include back braces but these are known to weaken the bones and lead to more fractures, physical therapy to strengthen the muscles around the spine and medication to relieve the pain.

Surgery becomes an option where other medications fail and the pain persists for more than two months. The surgeries performed are vertebroplasty, spinal fusion and balloon kyphoplasty.

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