Low-Tech Tricks Help Fractured Spines Heal

Because they are the hardest material in our bodies, it can be difficult to remember that our bones are always changing -- their cells are in a constant state of renewal, with new bone cells always being created and old bone cells always being destroyed.

But this balance of regeneration and destruction can get out of whack as we age -- and when bone cells break down faster than they are made, osteoporosis is the result.

Like hypertension, osteoporosis is a silent disease. It may advance quietly for years, until a person’s bones become so fragile that even actions as small as turning or bending can cause a fracture. The delicate bones of the spine are those most at risk.

Many older women develop fractures in their vertebra, and two-thirds of them don’t seek medical help because they don’t feel much pain as a result. But in some people, these fractures cause persistent, sometimes excruciating pain.

Physical therapy researcher Kathy Shipp, PT, MHS, PhD, is looking at interventions that can ameliorate this pain and assist in healing these cracked protectors of the spinal cord.

Staying Stable

For fractured vertebra to heal, they must be stabilized -- a challenge in this most mobile set of bones. One of the most common ways to do so is surgery -- procedures called vertebroplasty and kyphoplasty can fill the degraded bone with cement.

These procedures often relieve pain, but they are still undergoing formal study to determine their long-term effects. Some patients -- and even some physicians -- forego these procedures due to questions about side effects and effectiveness.

Shipp believes that physical therapy alone can go a long way toward stabilizing these fragile joints, and a pilot study she conducted makes the case for her hypothesis. In her study, a small group of elderly women were randomly assigned to either standard care or home visits from physical therapists.

“We taught them to find the straightest, most erect position of their trunk, and to move so that they stayed in that position. We worked on conducting daily activities while maintaining that position -- getting up and down from a chair, brushing their teeth, washing dishes, moving around in bed.”

These women also were given high-quality rolling walkers, so that their spine would be better stabilized and under less pressure when they were walking.

Though Shipp describes the techniques as “just very basic movement retraining,” she says they made a world of difference in the study participants’ reported pain.

The women who received the home visits had far less pain than the control group -- a 90 percent decrease after three months, where the control group had a 33 percent increase in pain. This study was a small one, so Shipp hopes to be funded to test the technique in a larger group. If her methods are proven successful, they could provide a new standard of care for vertebral fracture patients.

“My belief is that it won’t take all the pain away, but it will help people get through their recovery phase and make it less hard on them."