Physical Therapy for Vertebral Compression Fractures

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Physical Therapy for Vertebral Compression Fractures

Physical Therapy for Vertebral Compression Fractures

What are Vertebral Compression Fractures?
Vertebral compression fractures are extremely common in patients with compromised bone density, as in the case of osteoporosis or osteopenia. In patients without compressed bone density, typically extreme vertical trauma is involved. About 1.5 million fractures occur annually due to osteoporosis, with half of these fractures occurring at the spine.

How are Vertebral Compression Fractures diagnosed?
The gold standard for diagnosing compression fractures is through imaging, such as an X-ray or MRI. In lateral view X-rays, compression fractures are characterized as a wedge deformity, with a loss of vertebral height that is greater in the front of the vertebra.

Symptoms of a Vertebral Compression Fracture include:

History of major trauma, such as a car accident, fall from an elevated surface, or direct blow to the spine
Older age
Prolonged use of corticosteroids
Point tenderness over the site of fracture
Increased pain with weight bearing

How can Physical Therapy help after a Vertebral Compression Fracture?
Some patients with neurological deficits or complications may be recommended surgery by their Physician. The two most common surgeries are a kyphoplasty and vertebroplasty, which involve injecting cement into the bone.

Physical Therapy treatments include:

Manual therapy to reduce pain
Dry needling to reduce pain
Exercise to promote improved posture and stand fully erect
Strengthening exercises to muscles around the compression fracture
Osteoporosis management strategies to lessen risks of future compression fractures

References:

Delitto, Anthony, et al. “Low Back Pain.” Journal of Orthopaedic & Sports Physical Therapy, vol. 42, no. 4, 2012, https://doi.org/10.2519/jospt.2012.42.4.a1.
Hwang, Michael, et al. “Postoperative Physical Therapy Following Balloon Kyphoplasty for Management of Vertebral Burst Fracture: A Case Report.” JOSPT Cases, Vol. 3, No. 1, 15 Feb. 2023, https://doi.org/https://doi.org/10.2519/josptcases.2022.11399.
“Osteoporosis and Kyphoplasty.” University of Maryland Medical Center, https://www.umms.org/ummc/health-services/orthopedics/services/spine/patient-guides/osteoporosis-kyphoplasty#:~:text=Approximately%20half%20of%20these%20fractures,the%20first%20increases%20five%2Dfold.
Ross, Michael D., and Ryan L. Elliott. “Thoracic Spine Compression Fracture in a Patient with Back Pain.” Journal of Orthopaedic & Sports Physical Therapy, Vol. 38, No. 4, 2008, pp. 214–214., https://doi.org/10.2519/jospt.2008.0404

How do we track your progress?

We define patient-centered goals as what you hope to accomplish from physical therapy. While these are typically activity-specific goals, often patients report they just wish to experience less pain.

Benefits of Spinal Manipulation

Spinal manipulations include positioning of a patient and then performing a single, rapid movement to an area of the spine including cervical (neck), thoracic (upper back) and lumbar (lower back).

Physical Therapy for Kyphosis

Kyphosis refers to the normal rounding of the upper back. Occasionally, people will have excessive rounding and in this case the rounding/kyphosis is referred to as hyperkyphosis (hyper = above normal). This rounding increases naturally as we age and there is no standard definition of hyperkyphosis versus normal changes associated with aging. An increase in kyphosis is more common in women than men. The cause of an increase in kyphosis is due to muscle weakness and impairments in flexibility/mobility.