severe pain after compression fracture

    
      Re: severe pain after compression fracture
    


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Posted by CCF Neurosurgery MD on November 13, 1997 at 11:37:00:

In Reply to: severe pain after compression fracture posted by Lynn DeLong on November 06, 1997 at 06:06:35:

: My husband suffered two severe compression fractures on either side of a spinal fusion after a fall in July.Four months latter he is still in serious pain after any activity,  no matter how minor. Darvocet masked the pain somewhat and allowed him to function, but he took too much and his physician switched him to Ultram for fear of addiction.Non narcotics don't seem to do the trick, however, and again he is unable to function for very long. Is this normal? What do you suggest in the way of pain management? Depression is also a consideration.Any suggestions for relief would be welcome!
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Dear Lynn,
A few things to think about for your husband's pain.  He previously had a fusion
with subsequent trauma and compression fractures.  Whether anything can be
done surgically depends on your husband's type of pain and the radiographs
that were taken.  Surgery would be considered for failure of the previous fusion,
a severe compression fracture with instability and spinal cord impingement
from either.  
Short of the above surgical issues, your husband should be treated conservatively.
Pain management would include oral analgesics (as you have tried), NSAIDS
(ibuprofen, etc...), steroids and injections of these locally, if indicated.
Some physical therapy would likely be useful as well.  The vast majority of
back pain is of musculoskeletal origin and can be treated with the above and
rest.  Your husband must take it easy on his back, i.e. no working in the garden,
lifting, etc...
You should speak to your surgeon as to his opinion of the structural stability
of your husband's spine.  If no surgical issue arises, the surgeon will likely
recommend the conservative measures mentioned.  This type of injury often
takes months to improve.  Try not to get impatient with the seeming slow progress/
of healing.
Good luck.