Alexander Kiefer, MD
Sudden Back Pain May Be an Unrecognized Broken Bone
Bone density in both women and men starts to decrease after age 40, but the loss of density greatly accelerates after women enter menopause. Although most compression fractures occur in patients with osteoporosis, a disease characterized by very low bone density, one-third of vertebral compression fractures occur in patients without osteoporosis and occasionally in patients with only slightly decreased bone density.
If it occurs suddenly, patients can experience sudden severe back pain that often wraps around the sides and is felt in the chest. Because of this, it is sometimes confused with diseases of the heart or the lungs. The pain is often worse when standing, sitting-up, or walking around. Lying down can make the pain decrease. Because of the loss of height of the spine, a patient’s chest or belly may become smaller, which can result in difficulty breathing and decreased food intake. If very severe, the spinal cord can become damaged, leading to sudden weakness, numbness, or loss of control of bowel and bladder functions. These severe cases are emergencies that require immediate evaluation in an emergency room. Patients who have symptoms of a fracture, should see their doctor. After a thorough clinical evaluation that suggests a vertebral compression fracture, they will often be sent for an MRI. This imaging shows the level of the fracture and also reveals whether it is old or new. Some compression fractures can be treated with pain medicine, physical therapy, and bracing. However, many cases continue to cause severe pain and long-lasting health effects unless treated more thoroughly. Unfortunately, many patients and physicians are not aware that there is a minimally invasive procedure called a kyphoplasty that can quickly, safely, and effectively treat a patient’s pain without the long-term use of opioids and other pain medications. Kyphoplasty can often be performed in a doctor’s office, preventing the need for an overnight stay in a hospital. After the patient is given a medicine to relax during the procedure, they lie on their belly. A doctor then uses an x-ray machine to locate the fractured bone and places a narrow tube into it through a very small opening in the skin. A small balloon is inflated within the bone to create a small space and the fracture is then filled with special bone cement, which takes 5-10 minutes to harden. The tube is then removed. The entire procedure generally takes 45-60 minutes. Many patients feel immediate pain relief and are able to return to their daily lives the day after the procedure. However, some patient’s may take a week or longer to feel better.
Kyphoplasty most successfully reduces a patient’s pain within two weeks following a fracture. Unfortunately, if the window of opportunity is passed, the pain can become more challenging to treat and further complications can occur. As awareness of this condition increases and more patients are offered this minimally invasive therapy, it is hopeful that fewer patients will have to live with the severe pain that results from vertebral compression fractures and can return to their full lives more quickly and comfortably than before. If you are experiencing pain that is limiting your daily activity, causing breathing problems, or general weakness and fatigue, there are various safe, effective, and minimally invasive therapies available. Schedule an in-
office pain evaluation at Georgetown Pain Management to determine if you’re eligible for Kyphoplasty or other pain therapies. Most insurances are accepted and new patient evaluations are currently being scheduled.