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Instep Dance Magazine Articles

Reprints of monthly column as first appearing in Instep Dance Magazine (now out of print).

July 2000

Back Pain - Part 8: Compression Fractures (Ouch!)

By Rick Allen, DC

"Better health leads to better dancing."

Last month, I told you about treating a fellow attending a conference whose subluxated rib was so painful that he could barely breath. This month, I will review an injury that can put you on the ground in pain: compression fractures of the spine.

Compression fractures of the spine are the result of a combination of forces created when bending forward and lifting a heavy object. They are more common in patients who have osteoporosis. Lateral radiographs (x-ray pictures) may show a distinct wedge deformity and step defect. The compressed vertebra looks like a squished pancake, narrower in the front (figure 1). The fracture of the vertebral end plate causes acute symptoms for about two weeks, as long as there is no dislocation.

Mary Lou Griffith's recent compression fracture has been typical of what happens. About two weeks ago, she phoned me for emergency care. She had been lifting an elderly man for whom she is a caregiver, when he lost his balance as his legs gave way, forcing her into an awkward, forward-bending position. "POP" went her back - loud enough for those around her to hear it go. She went down in extreme pain, barely able to move. She called for help.

She arrived bent over, hobbling from the car with the help of a friend. Initial examination showed severe localized low back pain. Thank goodness there were no "red flags", such as severe pain down the legs, loss of muscle strength or reflexes in the legs, or loss of bladder or bowel function. This made a disc herniation unlikely and gave us some breathing space. It looked like she might have just strained her back badly. However, even with gentle treatment and wearing a low back support, it didn't show signs of getting better in a few days. Sure enough, lumbar x-ray pictures showed a small compression of the top portion of her fourth lumbar vertebrae (L4) without any dislocation, right where the pain was centered.

I had her continue wearing a strong low back support, gave her a heel lift to help balance her low back, and had her take some natural herbs to relieve pain, spasm and inflammation. I crosschecked with a medical doctor to see if there was anything else we could do to help Mary Lou. He suggested some prescription anti-inflammatory medication if necessary. The pain level lowered over the past week, so it really has been just a matter of time as the body heals itself.

As this process continues, I will introduce gentle chiropractic and massage treatment. We are also having a bone density test done. As a preventative measure for the future, I have advised her to do four things known to help increase bone density:

  1. Continue taking her calcium-magnesium supplement (1200 mg calcium plus 600 mg magnesium).

  2. Add a bone health supplement that contains ipriflavone, a soy product that has been show to help with the absorption of the calcium-magnesium supplement and increase bone density naturally.

  3. Carefully increase weight-bearing exercise, starting with simple floor exercises, then adding ball exercises, and then, as she is ready, adding light, progressive weight training.

  4. She is reading two books from my lending library to bring herself up to speed on natural hormone replacement therapy. Because I am not an expert in this field, I have recommended that she consult a knowledgeable Naturopath or Medical Doctor about alternatives to pharmaceutical hormone replacement therapy.

XRAY of spine fracture
Diagram of spine fracture
Mary Lou Griffith

References:

Taking Your Back to the Future by Michael Gazdar, D.C., C.C.S.P.
Essentials of Skeletal Radiology by Terry Yochum, D.C., D.A.C.B.R. and Lindsay Rowe, D.C., D.A.C.B.R.
What Your Doctor May Not Tell You About Menopause by John Lee, M.D.
Natural Hormone Replacement Therapy by Jonathan Wright, M.D. and John Morgenthaler. (Available at the Professional Plaza 102 Pharmacy on NE 102nd Avenue between Glisan and Burnside in Northeast Portland. This is a "compounding pharmacy" that can make special hormone replacements. Compounding pharmacies are also located at Nature's stores around the Portland metropolitan area.)

Other articles directly about posture are:

You are invited to watch a video of good and bad posture on the beach in Fort Lauderdale, Florida by Paul St. John, LMT. It is a real eye-opener. Please call if you would like to watch it at my clinic.

Next: Hopefully, we'll be able to check on improving conditions of Mary Lou's compression fracture and my own posture as I improve my ability to stand tall in my future articles.

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