Osteoporotic vertebral (spinal) fracture rehabilitation

In osteoporosis the bones lose strength, and the vertebrae in the spine can collapse under normal loads. The NHS lists broken bones in the spine as a common osteoporosis injury, and says that collapsed vertebrae can happen after minor trauma such as coughing. Some people notice sudden severe back pain, while others have fractures found later on imaging.

Rehabilitation here has two aims. One is to get through the painful early weeks and rebuild function. The other is to recognise that a spinal fracture from fragile bone is a signal that further fractures are possible, so assessment and treatment of bone health belong in the plan.

The Royal Osteoporosis Society says the primary recommendation is to remain as active as possible, because prolonged bed rest is linked with chest infections, blood clots and loss of muscle strength. The NHS suggests painkillers and hot and cold treatments such as warm baths and cold packs for fracture recovery.

Practical activity usually means short, frequent walks and changing position often, within what the pain allows, rather than staying still or pushing through severe pain. A GP or physiotherapist can advise on the pain relief that suits you, and the Royal Osteoporosis Society notes that pain unresponsive to medication is the situation in which specialist procedures are considered.

The Royal Osteoporosis Society says a spinal fracture heals in 6 to 12 weeks, and that spinal bones do not return to their previous shape. Where several vertebrae have collapsed, the society describes height loss and spinal curvature, which can in some people cause breathing difficulties and can aggravate arthritis because the spine's shape has changed.

This is the reason early recognition matters. One fracture that is treated and followed by bone-protecting treatment has a different outlook from repeated fractures left unaddressed. The pages used here do not give percentages, so ask your clinician about your own risk.

For severe, persistent pain that medicines do not control, the Royal Osteoporosis Society describes two procedures. In vertebroplasty, bone cement is injected into the fractured bone to stabilise it. In balloon kyphoplasty a balloon first creates space before the cement is injected. Both take a couple of hours.

The society states that serious risks are uncommon but include infection and nerve injury. These procedures are for selected people, not routine for every fracture, and a specialist will weigh them against the likelihood that the pain will settle with time.

The Royal Osteoporosis Society notes that exercise after healing helps rebuild back muscle strength, and offers material on safe movement, daily living and clothing adaptations. The NHS recommends regular exercise for bone strength in general, though its page gives no spinal-specific programme.

A physiotherapist experienced in osteoporosis can show which movements to favour and which to avoid, for instance heavy forward bending with load or sudden twisting. Without a published programme on the pages used here, treat any specific exercise list you find online with caution until it has been checked with a clinician who knows your scans.

The NHS describes several osteoporosis medicines, including bisphosphonates, raloxifene for some postmenopausal women, parathyroid hormone for severe cases, and denosumab and romosozumab when other treatments are unsuitable. It states adults need 700 milligrams of calcium a day and 10 micrograms of vitamin D, and that everyone should consider a daily 10 microgram vitamin D supplement in autumn and winter. Treatment choice depends on age, sex, fracture risk and medical history.

Falls prevention is part of rehabilitation. The NHS suggests removing hazards at home and having regular sight and hearing tests. Anyone with sudden new back pain, or pain with new weakness, numbness, or loss of bladder or bowel control, should seek urgent medical help through NHS 111 or A&E.