If you have spondylitis and have experienced a spinal compression fracture, you are not alone. Nearly one million compression fractures occur every year in the United States, and they are up to four times more common in people with ankylosing spondylitis. People with spondylitis are also more susceptible to osteoporosis, which is a leading cause of compression fractures. While recovering from a spinal compression fracture, there are steps you can take to be more comfortable and support the healing process.
“I have had many injuries and accidents, including two compression fractures and a spinal hematoma,” said one member of MySpondylitisTeam. “But today, many years later, I am doing much better.”
Spinal compression fractures, also called vertebral compression fractures, are small cracks or breaks in the vertebrae (bones that make up the spine). In people with spondylitis, they can result from a fall while standing and other minor types of trauma.
If your doctor suspects you have a compression fracture, they will likely perform a physical exam, especially if you have back pain, lower back pain, kyphosis (very curved spine), or a hunched appearance. They may also recommend an X-ray, an MRI, a CT scan, or a bone density test.
Depending on where and how severe your compression fracture is, it may heal in eight to 10 weeks or it can evolve into a long-term condition. If you have surgery, recovery will likely take longer. Your doctor can give you the most accurate prognosis.
Treatment goals for a spinal compression fracture often include reducing or eliminating pain, stabilizing the bone(s), and restoring mobility.
Unlike spinal fractures caused by accidents or sudden trauma, compression fractures caused by spondylitis often do not injure the spinal cord. Up to 30 percent of compression fractures occur while the person is lying in bed. Although more severe cases may require surgery, initial treatment approaches are usually noninvasive and don’t require surgical treatment.
If appropriate for your compression fracture, your doctor may recommend:
If your doctor recommends a back brace, ask about long-term risks. In some cases, a back brace can weaken the bones, potentially leading to more fractures in the future.
If you have severe pain or do not respond to initial treatments, your doctor may recommend vertebroplasty. This outpatient procedure uses bone cement to stabilize spinal compression fractures. Kyphoplasty is similar, but during this procedure, the surgical team uses balloons to create more space before applying the bone cement. If your doctor recommends spinal fusion surgery, minimally invasive options are available.
One member of MySpondylitisTeam who had surgery for a compression fracture said that the experience went better than expected. “The scar was a neat line that fades well in time,” she said. “I had staple clips and thought they would hurt coming out, but they didn’t. The compression of the spine affects us all differently, but surgery can stop it from getting worse.”
Your doctor will provide a recovery plan based on your diagnosis, treatment, overall health, and personal goals. It’s essential to follow the plan they have outlined. The tips below can help you to feel more comfortable at home and better understand your recovery plan.
Medication to relieve pain from a compression fracture will likely be one of the first things your doctor discusses with you. If not, ask. Be sure to tell them exactly where you hurt and whether the pain is sharp or dull. They can recommend over-the-counter or prescription medications or a combination of the two to help you get the pain relief you need.
Common medications used to treat pain from compression fractures include:
Some doctors may also recommend calcitonin salmon, a medication that increases the calcium levels in the bones and can reduce the pain associated with a fracture.
In addition to pain medication, members of MySpondylitisTeam find pain relief in other ways. “I used ice yesterday, and it really helped,” said one. “Heat feels good in the morning when I get up, and I believe it loosens up my back,” said another.
If you need help finding pain relief, talk to your doctor to get the right care. Pain medication does not directly help your bones heal, but it should make you more comfortable so you can rest. It should also enable you to remain mobile so you can work to regain your strength.
Doctors typically recommend bed rest for compression fractures because it gives your body a chance to start the healing process. However, because osteoporosis can become worse from a lack of movement, you should transition from a short period of bed rest to limited activity as soon as it is safe. Ask your doctor how long your bed rest should last.
Plan to make your bed rest period more enjoyable. You may want to borrow books from the library, download new movies, or save your favorite shows to binge-watch. You may also find it helpful to have a friend or family member on call to help with adjusting the temperature in the room, delivering meals, and refilling your water glass so you can stay in bed.
While you heal from a compression fracture, some sleeping positions and mattresses will be more comfortable and beneficial than others. Keep experimenting until you find what works for you. Sleep is an important part of the healing process. Here are a few tips:
Physical therapy and rehabilitation exercises will likely be part of your recovery plan. A physical therapist or another qualified member of your care team can work with you to set goals, create an exercise schedule, and show you some appropriate exercises.
If you have a low-impact activity you like to do, such as walking or water aerobics, ask about incorporating it into your recovery plan. If it’s not appropriate now, it may be later in your recovery.
“My doctor gave me gentle exercises to do three times a day, which I still do to help with stiffness,” said one member of MySpondylitisTeam. “I didn’t see any improvement at first, but in time, I did. Now, I am out of a wheelchair and using a walker.”
Another MySpondylitisTeam member said exercise and stretching help her. “I stretch several times a day, every day. With two spinal compression fractures and more on their way, I rarely sit too much. I walk, too, and I’m grateful and excited to use my new gym.”
If you have a spinal compression fracture or another back injury, talk to your doctor before starting a new exercise program.
While you heal, keep the lines of communication open with your doctor and your loved ones.
If you are in pain, have questions about your recovery plan, are concerned about changes in your health, or have questions about whether you should be doing something during recovery (e.g., exercising), talk to your doctor.
Whether you need help with meals, errands, or walking your dog or just want someone to keep you company, tell your friends and family members exactly what you need. People care about you and want to help. This is a time to let them.
Once you have had one compression fracture, you are more likely to have another. The good news is that you can take steps to lower your risk of a future injury.
Osteoporosis is a leading cause of compression fractures. You can strengthen your bones by eating a healthy balanced diet and getting the recommended amounts of calcium and vitamin D. Calcium-rich foods include milk and other dairy products, dark-green leafy vegetables, and soybeans. You can get vitamin D from fatty fish, fortified milk and milk products, fortified cereals, and other sources. If you have questions about supplements, talk to your doctor.
Weight-bearing exercises like walking, tai chi, hiking, dancing, and tennis can also help strengthen your bones, as can quitting smoking and other tobacco products. You can also ask your doctor about medications to help slow bone loss and reduce your risk of future fractures.
Spinal compression fractures in people with spondylitis are often the result of falling. Even a minor fall can have long-lasting effects. Here are several ways to prevent falls:
MySpondylitisTeam is the social network for people with spondylitis and their loved ones. On MySpondylitisTeam, more than 87,000 members come together to ask questions, give advice, and share their stories with others who understand life with spondylitis.
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