Monday, February 3, 2014

Vertebral Compression Fracture bad fall at the entrance to an escalator, Smoking key risk factor for spine degeneration

Dealing with a broken back...  Debilitating degenerative spine/discs/osteoarthritis... I quit smoking Sept 2012

very good video about whats wrong with my spine; DDD degenerative-disc-disease-interactive-video:
http://www.spine-health.com/video/degenerative-disc-disease-interactive-video#vm_A_cf8e66d4

I recently had a bad fall at the entrance to an escalator and fell 2 or 3 steps deep in (I was tripped by a raised lip in a faulty floor joint where the metal escalator entrance met the floor. The mall had recently replaced all the escalators), I had to put my right knee down hard and my arm out on the stairs floor to stop me from tumbling all the way down (I could not grab the hand railing because there was a lady in front blocking my reach and I would have pushed her and she would have fallen down the stairs too).

The force from the jolt jammed and re injured my lower back in the same place that I have spent the last year in rehab for. I am in pain again everyday and spend the afternoons laying down on a heat pack. My year long healing progress has been set back 8-10 months to the point where I was still in physical therapy 3 days a week. Now I really can't afford PT and will try cheaper massage therapy. I just hope the inflammation will down soon and can get back into agua therapy on my own at the pool. I believe I have a stress or compression fracture, osteoporosis and osteoarthritis even now at my age of 59 (next month is my birthday in early March), and the best thing to do is rest for a month or 2 and limit my activity.

Feb 6, Really bad day pain got especially bad last night and now pain first thing in the mornings. I will go see if my massage lady is working today... massage helped, better for 2 days, then back to same pain level.
bought some fish oil, vitamin b, plasters and a new back belt this week, I am walking some but not riding any busses or swimming yet...

Feb 10, no improvement, plus some numbness in left arm and leg started 2 days ago, I continue to rest and research. I can only sit 2-3 hours before the pain is so bad I have to lay down. More massage and started vitamin D and calcium today. I read Compression fractures tend to heal completely in about 8 to 12 weeks. Patients who have one compression fracture are much more likely to have more. 
A compression fracture occurs when the normal vertebral body of the spine is squished, or compressed, to a smaller height. This injury tends to happen in two groups of people. First, are patients who are involved in traumatic accidents. When a load placed on the vertebrae exceeds its stability, it may collapse. This is commonly seen after a fall. 

What may cause a vertebral compression fracture?

  • Osteoporosis: This is a condition where your bones become weak and brittle. It is more common in those over 60 years of age, and in women after menopause (change of life). Ask your caregiver for more information about osteoporosis.
  • Injuries: Fractures can happen if you are in a car accident, or if you fall down. You may also get fractures when playing sports, or if you get in a fight. People who have weak bones can get fractures by bending forward, standing from a seated position, sneezing, or strong coughing.

Nonoperative Therapies

Physical therapy

Heat, massage, analgesic medications, and bed rest may provide symptomatic relief. (However, bed rest and immobilization can cause disuse, osteopenia, and an increased risk of a thromboembolic event.)
Bracing used to be common. However, the use of extension bracing has become controversial because of concerns regarding the placement of increased stress on the posterior elements of the spine.
Patients should be treated for their osteoporosis with anti-osteoporotic medications, including second-generation bisphosphonates, as well as with (daily) 1500 mg of elemental calcium and 400 IU of vitamin D.

What are the signs and symptoms of an acute vertebral compression fracture?
An acute fracture occurs suddenly, such as from a fall. You may not have any signs and symptoms with a mild fracture, or you may have any of the following:
  • Back pain that gets worse when standing up or walking. The pain goes away when you lie still.
  • Muscle spasms in your back.
  • Pain when the fracture area is touched.
  • Problems passing urine, or having bowel movements.
  • Sudden, severe, and sharp back pain.
  • Sudden weakness in your arms or legs. 

    Tobacco smoking is a key risk factor for spine degeneration. Recent studies implicate DNA damage as a cause of spine and intervertebral disc degeneration. Because tobacco smoke contains many genotoxins, tobacco smoking promotes spine degeneration by inducing cellular DNA damage. One of the chief effects of smoking on the spine is that smoking contributes to atherosclerosis. Atherosclerosis is when plaque or other material builds up on the inside of blood vessels, causing decreased blood supply especially to areas that are fed by very small vessels. The bones and discs of the spine are supplied by these small vessels and are affected by atherosclerosis which decreases the spine’s ability to heal itself.

    One of the chief effects of smoking on the spine is that smoking contributes to atherosclerosis. Atherosclerosis is when plaque or other material builds up on the inside of blood vessels, causing decreased blood supply especially to areas that are fed by very small vessels. The bones and discs of the spine are supplied by these small vessels and are affected by atherosclerosis which decreases the spine’s ability to heal itself. This eventually leads to degeneration of the spine and the onset of pain. In this way, smoking increases the risk of developing atherosclerosis related to back pain.
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    • Paul Rainwater Over time, the bone is used up faster than it can be rebuilt causing osteoporosis and other degenerative conditions causing pain.

      Another connection that has been made between smoking and low back pain is the message of pain itself. Smokers have been 
      found to have higher ratings of pain than nonsmokers [Source: Ackerman, Scott, Vogt]. While the exact reasons for this are not entirely clear, it appears to have some connection with chemical interference with the body’s natural hormonal activity for pain detection. Essentially, the hormones and chemicals that help the body deal with pain are inhibited by smoking.

      Other questions about smoking include whether smoking has an effect on intervertebral discs or on neck pain.

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