Written by Babatunde Carew
Spoon Feed
Physical therapy (PT) can help patients recover from vertebral fractures by reducing pain, improving movement, and preventing future fractures, especially in older adults.
Step on a crack? PT’s got your back
- Vertebral compression fractures are the most common complication of osteoporosis, affecting an estimated 1.5 million Americans annually, causing back pain and pain-related disability.
- Current guidelines highlight conservative care for most compression fractures, including medications and bracing, but do not comment extensively on the role of PT.
- Using evidence from meta-analyses and clinical guidelines, this review highlights that PT — including balance and resistance training — improves functional outcomes and bone health. Interdisciplinary, individualized PT is critical for recovery and long-term fracture prevention, particularly for older adults with osteoporosis, emphasizing early mobilization and tailored therapeutic interventions. [AI-assisted]
- Some notable limitations in this review include variations in study design and small sample sizes of the cited studies.
How does this change my practice?
In my current outpatient practice, I generally refer patients with acute vertebral compression fracture to Orthopedic Surgery to rule out a surgical fracture and to receive a temporary brace. Additionally, I treat co-existing osteoporosis and manage their pain with NSAIDs, opioids, and rarely, calcitonin. However, PT is not always in my early stage treatment plan, and some patients are not referred until they have lingering pain after weeks of conservative management. Going forward, I will certainly be involving PT as early as possible given this study’s emphasis on the role of early PT in relieving pain, restoring mobility, and preventing future fragility fractures in this population.
Source
Physical Therapy for Patients with Thoracolumbar Vertebral Fractures. Am J Med. 2024 Nov 17:S0002-9343(24)00753-8. doi: 10.1016/j.amjmed.2024.11.005. Epub ahead of print. PMID: 39557322
