Spinal Fracture: Treatment and Physical Therapy

Most spinal fractures happen in 18-25yrs of age and men suffer more from traumatic fractures rather than women. There are various types of spinal fracture: Compression, burst, flexion-distraction, and fracture-dislocation. Compression fracture, mostly happens due to osteoporosis, leads to a reduction in the vertebral height post-fracture. The osteoporotic weakened spine is unable to bear the stress and the pressure on it and this can lead to overactivity of muscles. The lower thoracic spine is the commonest site for compression fractures. Spinal fractures can be traumatic, pathological (osteoporotic or cancerous bone) or of some other origin. Dislocation or fracture-dislocation can also happen if the injury is severe, leading to ligament and disc damage. The fractures are diagnosed after the physical examination and x-rays, CT scans and MRI can further be used to confirm the diagnosis. Spinal fracture alters the spine biomechanics; biomechanically normal aligned vertebras control the proper transmission of weight and control the movements as well. Muscles would be under tension as the normal muscle physiology will also change.

What Are the Main Causes of Spinal fractures?

• Motor vehicle accidents
• Fall from a height
• Sports injury
• Violence
• Miscellaneous causes
• Osteoporosis
• Tumors (cancer)

What Are the Main Symptoms of Spinal fractures?

• Neck or back pain
• Sensory symptoms – tingling and numbness in limbs and trunk regions.
• Motor weakness – muscle weakness, muscle spasms and change in muscle tone.
• Bowel and bladder symptoms
• Paralysis – mostly due to spinal cord injury

The severity and location of the spinal fractures determine the symptoms experienced by the patient.

Treatment

The spinal fractures can be managed conservatively or surgically. Conservative management includes pain management, stabilizing the fracture site and improving bone health. If osteoporosis is the causative factor, then it has to be managed as well. The physical therapist will assist you in performing various exercises during the recovery phases of spinal fractures. A physical therapist will train you to perform stretching exercises, strengthening exercises and core training exercises in a correct manner. Specifically for pain management, medicines and physical therapy will help. Drugs like ibuprofen or acetaminophen would be helpful. Calcitonin might also be prescribed as it helps in reducing the pain in compression fractures. Although, most of the compression fractures heal within 3 months of injury.

1. Rest – Rest is recommended for the initial healing phase, but one should start to be more active once the doctor recommends it.
2. Bracing – it reduces the pressure off the fracture site and limits the movement. As there will be lesser pressure on the fracture site, it will facilitate faster healing of the fracture. Although it should not be used for prolonged periods as prolonged use can lead to muscle atrophy.
3. Physical therapy – Once you are out of the rest phase, a physical therapist can help you recover much faster. Back strengthening exercises can help you avoid the spinal fractures. Various weight-bearing exercises can be performed such as walking, dancing and tai chi, etc.
4. Preventing future spinal fractures – Besides rest and physical therapy, some medicines will help you build good bone health and prevent the future likelihood of fractures and these include bisphosphonates (prevent bone loss), Denosumab (post-menopause), Romosozumab (improves bone health) and parathyroid hormone (helps in forming new bone tissue).

It is important to consult a doctor or a team of doctors and physiotherapists together as we do at AktivHealth so that your condition can be properly assessed and the treatment started accordingly to include the physical therapy and medication if needed. Do not go in for self-medication. Stay Healthy and Active!!

Written by: Parminder Kaur, Physiotherapist, AktivHealth