Those with Vertebral Fractures - Please share your story and advice
I am 74 with severe osteoporosis, worse in my spine (T-score -4.1). I believe I recently developed a vertebral fracture and will see my PCP this week. I am feeling very scared and have a lot of worries about the recovery process, developing more fractures, and what to expect in my life going forward. I would like to hear from anyone who’s had one or more vertebral fractures. Could you please share your story and let me know what your experience has been, how your life has been affected, and if you have any suggestions or advice?
There wasn’t a fall or movement where I suddenly felt sharp pain. It was a gradual process that started with some low and mid-back pain (not severe). Two weeks later, I noticed pain at my spine, about waist level. The pain is worse with certain movements such as bending forward or leaning back against a chair and that area of my spine is tender if I press on it. The pain is tolerable with 1-2 tylenol a day. I am able to walk and sleep without pain, except for when I turn over in bed.
When I see my Dr this week, I assume she will schedule an X-ray of my spine. I read compression fractures don’t always show up on X-rays. If that’s the case, should I ask for a CT-scan or any other test? Is there anything I should do, such as movements to avoid etc, to prevent the fracture from getting worse before it can heal, and to prevent more fractures? Did you wear a brace?
I’m in discussions with my endocrinologist about medication. I have parathyroid issues that probably rule out Tymlos or Forteo. I’m consulting with an endocrine surgeon tomorrow. That would leave Fosamax or Evenity as options. But rather than discuss medications right now, I am mostly looking to connect with others with fractures.
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@daisy17 I am sorry for what you are going through. I am about your age and have 7 spinal fractures: three from a traumatic fall in 2006, three from one unwise bending movement in 2021, and one I didn't know about. Healing in 2006 and 2021 was painful for a few months but stabilized. The main effect has been that I can't life much, open windows, etc.
Vertebral fractures do show up but not in the first 24-48 hours after the fracture, I was told.
With a DEXA score of -4.1 do you have an endocrinologist and are you going on medications? Tymlos was my choice because the dose is adjustable. It is reputed to help with healing of fractures as well. I haven't fractured since I went on it in 2021.
You sound very much like me, however I had excruciating pain so bad I went to ER. Where they did CT scan, referred me to neurosurgeon for kyphoplasty in two vertebrae . Which I did have and was helpful in eliminated the pain. However I have since developed several small fractures ( which is common from what I hear) above and below where the procedure was preformed. They are tolerable.
I'm 64 and had a vertebra fracture in January. I had a severe cough that lasted a few weeks. The night it happened, I was lying in bed coughing and twisted my upper body to spit out phlegm. The force of the cough along with the twisting in bed (a big no-no) did my spine in. I had an MRI to confirm the fracture. My lumbar t-score is -2.8.
Regarding bracing; My spine doctor (a top spinal surgeon at NYU) didn't believe in bracing because it weakens the muscles although most spine docs do recommend bracing until the bone heals. Interestingly, my spine doctor gave me absolutely no physical limitations although both another doctor and a radiologist friend told me not to bend for 3 months (it takes 3 months for the bone to heal).
After that, any discomfort I had in my back (before the fracture I never had back issues), was from my body/spine adjusting to its new alignment along with its ligaments and muscles. Now I have mostly good days (pain level 0-2) but I also have osteoarthritis so any bad days (impending rain, high humidity) could be the cause of that. And sometimes I have a bad day(s) (pain level 4-6) and I can't figure out why but they do pass.
As far as life after fracture, you have to be careful bending from the waist. I just don't bend that way any more (I'd love to try but I don't want to take the risk). Don't strain yourself, say, like opening a window. I arranged (with help) my kitchen to put frequently used items (pots/pans, small appliances) that had been on a lower shelf or drawer to a waist-level height - so no picking up anything heavy from the floor or a low height. I also recommend a reacher to pick up lightweight items from the floor until the bone heals. I bend with my knees now to pick up lightweight items but again, I don't lift anything heavy from the floor. I have my husband put laundry detergent/bleach/fabric softener/dishwashing detergent into smaller (lightweight) containers so it's manageable for me to lift. My daughter helped me clean out the lower shelves in closets and kitchen cabinets which are now used only for lightweight items. I use a kneeling pad occasionally if I have to, say, open a lower drawer but I don't want to crouch that long (I don't have great knees either).
My body/spine has now adjusted to its new norm. I'm not 100% and never will be but I've adapted. After I fractured and certainly after the 3 months healing time, I was very anxious if any movement was going to make the pain/fracture worse but my PT kept telling me that the body is meant to "move" so I do so within reason.
Here's the most important advice: Be very mindful of your movements. Watch your step at all times. I walk a lot and I'm always looking for a small rock or branch that could cause a mis-step or a fall. Be mindful of stepping off curbs. Hold onto handrails even if you don't think you need to. Wear sturdy footwear even around the house (I wear Merrill clogs). The point of all this is to do everything you can to prevent falling.
I wish you the best of luck. This is a wonderful forum where you'll learn so much from others going through what you're experiencing right now.
@daisy7 sorry I posted late and meant to say I can't lift much.
I have a soft brace with velcro that I only wear while lifting, very rarely. I was told to minimize use so that the muscles didn't atrophy.
I did not have kyphoplasty. The surgeon advised against it and said outcome would be the same with or without. It can help with temporary pain relief but he said pain would go down anyway and it did. I asked about reports of cement leakage into the lungs and also tendency for the glassy material to crack (and as @jm7 jmplies, it may make fractures of adjacent vertebrae more likely). That said, the structure of my spine is now bent forward "moderately" which causes some secondary pain. Kyphoplasty can sort of prop up the compressed vertebrae which addresses the forward posture and restores height.
PT (and OT) can be very helpful. An example: if I plan on cooking that requires water, I put the pot on the stove and use a glass to fill the pot with water so I avoid lifting a pot with water in it. I also slide pots with food along the counter rather than lifting. Another one: if I buy a six pack of small water bottles, I leave half in the car and carry half up, then go back (I have to walk a ways from car to apartment). Sometimes I put things in my coat pocket- like a seltzer bottle!
@daisy17 I, too, am very sorry for what you're going through.
I'm 64 and have 5 (or maybe 6?) vertebral fractures. The first was very painful and was just a fall off the edge of the bed while trying to get rid of a leg cramp back in 2020.
This year, 2024, I have broken 4 (5?) more vertebrae during three separate events. I broke 3 shoveling snow, something I can no longer do. After a dexa scan and MRI this Spring showing these 3 new vertebral fractures (from the snow shoveling) I returned to doing my bone exercises. I had stopped doing the bone exercises for 8 months due to a broken foot metatarsal and various other reasons. When I returned to the exercises I broke a vertebrae in the upper back and I learned I should have started out again using very low weights for the exercises. I now have a big kink in my spine at T7 and it still gives low pain at times. I didn't do kyphoplasty but maybe should have. It would have helped to keep my spine straighter but I was worried about exercise and the effect of kyphoplasty on surrounding bone. I'm now back dong the bone exercises but at a much lower level - 3 lbs for a deadlift.
Most recently (2024) I lifted something I shouldn't have and thought I broke another upper vertebrae but it didn't show on the X-ray. The pain level is low. From this thread I learned that fractures don't show up right away! Thank you for that information @windyshores. I also have some fractures that only showed up on the MRI.
I now understand, from personal experience and this forum, that upper spine vertebral fractures are worse than lower ones.
Not being able to lift what I used to be able to is the most limiting part of all this.
As far as pain, I have been fortunate to have most of the pain when the fracture is recent. A brace and medicine help a lot with pain during the early days of healing a vertebral fracture. I have had everything from excruciating pain to low pain for my vertebral fractures.
Anything you can do to stretch out your spine is very helpful with pain. I would ask your specialist if it is ok to do this during healing. I learned how to stretch my spine sitting, lying down and standing. About a decade ago, when I saw my 92 year old mother become bent over trying to read things she couldn't see well, I took an in-person posture class using the Gokhale Method. That is where I learned how to stretch my spine and how to bend my body using hip hinges. Both of these skills have helped me many times in my life, including improving healing from respiratory illness (opening the lungs to get more oxygen) as well as relieving pain and at least the knowledge of how to prevent injury with OP. https://gokhalemethod.com. Anyone can improve their posture and learn to move in ways to mitigate pain.
Bone exercises are proven to help bone density. I worked with an exercise physiologist at The Bone Clinic (https://theboneclinic.com.au) to get an exercise program specifically for me and increase my bone density. Over a two year period I increased my spinal T-score from -4.6 to -4.0 using only supplements and bone exercises. That was great until I stopped the exercises for 8 months and my T-score plummeted to -4.5. In my current condition The Bone Clinic recommends that I not do flexion (curving my spine forward) or weighted twists.
I am an active person and would likely have fewer fractures if I were more accepting of my condition. I also wish I had guidance from someone familiar with what can happen earlier on. I am glad you are getting information from other people's experiences at this stage.
I also have been reluctant to take medicine because of side effects. Now I know I need it. I am currently on Tymlos (2 months in) for my spine which had a T-score of -4.5 this Spring (2024).
I hope this is helpful to you and others.
I’m in discussions with my endocrinologist about medication. I have parathyroid issues that probably rule out Tymlos or Forteo. I’m consulting with an endocrine surgeon today, but have already had unsuccessful parathyroid surgery. That leaves Fosamax or Evenity as options. I'm afraid of both because of side effects but feel as though I have no choice. I've read Fosamax is not very effective at preventing new fractures, and would take at least a year to have even a minimal effect.
How did you find out about your small fractures, did you have pain and then an x-ray to confirm? Thanks.
I met with a PT familiar with osteoporosis who gave me exercises to do. After my pain started, she said I should continue with any of the exercises if they didn't cause pain. I also have fibromyalgia, so sometimes don't know if my pain is from that or not. It also makes it difficult to exercises some days. Thanks for your advice.
I had another MRI about 2 months ago because I felt like I wasn’t healing. Maybe I expected too much too soon. Although I still have some pain when I do too much it does seem to be getting less and less. Taking ibandronate once a month, along with calcium, vitamin D3 and k2 and magnesium daily. Walking daily
Did you Dr try xrays or CT scan first, but maybe the fractures didn't show on them?