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Osteoporosis Fractures: PT and Pain Management

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WebMD Feature

Having osteoporosis makes your bones more likely to break. The spine is the most common area where weak bones can give way.

Many fractures hurt, so treatments will ease the pain and help heal a broken bone. You can recover and come back stronger.

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Treating Pain

Good news: Pain usually does get better.

It may take time, though. "It can take a couple of months," depending on how deep the damage to the bone, says endocrinologist Ann Kearns, MD, of the Mayo Clinic in Rochester, Minn. While you're healing, there are pain treatments that don't call for surgery. They include:  

  • Pain medicines. These include acetaminophen (Actamin, Anacin AF, Tylenol), nonsteroidal anti-inflammatory medicines (NSAIDs), and prescription opioids. If you use opioids, it should be for a short time: "If possible, four weeks or less," says Chad Deal, MD, of the Cleveland Clinic. All drugs have side effects, so speak with your doctor about what’s best for you.
  • Hot or cold compresses. Applying heat or cold may help. "Some people like heat, some like cold," Deal says. "Whatever feels best."
  • TENS (transcutaneous electrical nerve stimulation). A TENS system includes a small, battery-powered machine, connected by wires to a pair of electrodes. The electrodes are connected to your skin near the pain source. A mild electrical current travels through your skin and goes along your nerve fibers. It may reduce pain by changing the way your brain perceives pain, experts say. One session takes about 15 minutes. "TENS is sometimes helpful -- not a game-changer but worth a try," Deal says.
  • Massage. This may give your muscles relief. Get your doctor's approval first, only get massage from a qualified therapist, and make sure the therapist knows about your osteoporosis and your fracture.

Other options that you and your doctor may consider as your fracture heals include using braces and muscle-relaxing prescription drugs. Some cases also involve taking calcitonin or parathyroid hormone, but that’s less common.

Surgery Options

Not every broken bone calls for surgery. For example, some wrist fractures do need a surgeon's care; others heal with only a cast. Even with a broken hip, some people only need to be monitored by a doctor.

If you have a fractured vertebra that is persistently painful, your doctor may offer two kinds of procedures, Deal says:

  • Kyphoplasty. The doctor inserts a tiny balloon to expand the broken vertebrae, fills the space created by the balloon with bone cement, and then removes the balloon. 
  • Vertebroplasty. This procedure is similar to kyphoplasty, but without the balloon.

Like all surgeries, there are risks. There has been some concern about the bone cement leaking, as well as pain and other complications to nerves from this procedure.

Deal says he uses these approaches "judiciously." When used in appropriate cases, he says, "it does result in remarkable improvement of pain."

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