Twist and Shout: osteoporosis and pain management

Osteoporosis is known as the silent disease. It sneaks up on you, and often the first inkling you have is when you trip over something or bend down to pull out a fat weed – and rise up yelling: ‘Eina!

And there it is – possibly the only noise osteoporosis will make. A fractured bone often proclaims its silent decay in the most painful way. And once this condition has made itself known, and confirmed by X-rays, there is a road ahead that may see you travelling a little differently in life.

While you may not feel osteoporosis itself, treatment will remain with you all your life. Keeping the pain at bay during bone repair, and also where collapse of bone impinges on nerves, is going to be uppermost in your thoughts. But there are many ways to effect repair, as well as strengthen the wellbeing of your bones.

Painful fractures caused by osteoporosis can take as long as 3 months to heal. In most cases, once the bone has healed, the pain will diminish. Pain that continues is chronic pain and is often the result of vertebral fractures, which can be difficult to deal with. But there are several approaches that can bring relief.

The common causes of common pain

Spinal compression: While any pain is the devil, back pain is probably the most debilitating. And the most common cause is a spinal compression fracture. This causes pain when you are standing and walking, and may only be relieved by lying down when the pressure is off the spine.

Twist and shout: Sudden twists and bends can cause even worse pain unfortunately. Although, why you would be doing either of these dangerous movements unless trying to swat a fly or impress with the latest fandango at a party, one can’t imagine. Be respectful of your back, move sedately and gracefully at all times. And work on strengthening muscles.

Loss of height: This is a tricky one – because as we age muscles and tendons may lose strength and a stooping posture can develop without you even noticing. A curved spine called kyphosis, also known as a ‘dowager’s hump’, can put pressure on the alignment of the spine, eventually causing pain to the shoulders, neck and mid-back region through the constriction of nerves and the compromise of muscles and ligaments.

Understanding the fragility: Bones are extremely fragile in the osteoporosis condition. Fractures can occur from simple movements that a healthy bone structure will take in its stride. Carrying a bag of groceries, twisting to get out of a car, or tripping slightly on a rug – all can cause a bone to break or vertebrae to crack. Be aware, and be cautious.

The pain management programme

Pain killers

Pain relievers like acetaminophenaspirinibuprofen, and naproxen are usually the most popular prescriptions. They’re safe for most people, but may cause stomach irritation and bleeding or liver problems if you take them for a long time. Always check with your doctor before taking any pain killers over the counter. Osteoporosis is a chronic condition, and therefore long term pain treatment may be necessary. All side effects should be understood beforehand and monitored.

Antidepressants

Interestingly, it has been found that antidepressant medication can help people with chronic pain. Even if the pain doesn’t truly subside, you will certainly feel better and have a stronger sense of achievement in the fight.

Heat and ice

Warm showers or hot packs can ease stiff muscles and help the pain caused by muscles bunching around fractured areas. Cold on the other hand, can numb aching areas and reduce swelling.

Physical therapy

Osteoporosis pain may make you nervous to move, and the tendency is to respond with inactivity. However, this can make things worse, as muscles can stiffen. Find a safe and guided exercise programme with an understanding therapist. A regular exercise programme helps you: regain strength and energy; relieve tension; increase flexibility; strengthen muscles; and reduce fatigue. Physical therapists also teach proper posture and exercises to strengthen the back and abdominal muscles without injuring a weakened spine. Water therapy in a pool is also excellent for improving back muscle strength and reducing pain.

Braces and supports

A back brace can relieve pain after a spinal fracture. It also helps you to move around normally while your spine is healing. But as soon as you can begin exercising, then begin immediately. Working on strengthening your muscles as soon as possible is very important.

Acupuncture

These treatments all may help ease pain and tension. But discuss it with your doctor first and be advised on what might be safe and what needs care. Acupressure is direct pressure applied to areas that trigger pain. Needles stimulate nerve endings and cause the brain to release endorphins. It may take several sessions before the pain is relieved.

Massage

Massage is always helpful, non-intrusive and relaxing. It relieves pain, relaxes stiff muscles, and smooths out muscle knots by increasing the blood supply to the affected area and warming it. Deep muscle massage should not be done near the spine if you have spinal osteoporosis. Light, circular motions with fingers or the palm of the hand is best in this case.

Relaxation

Slow, deep breathing helps to control pain by relaxing muscles, thus relieving tension and aching joints. Learning to relax takes practice, but relaxation training can help you to focus your attention away from the pain, thus slowly releasing tension from all muscles.

Be careful and be kinder to your bones before you get any painful messages. Love your bones!

 NOFSA (National Osteoporosis Foundation South Africa)

NOFSA is the only non-profit, voluntary health organisation dedicated to promoting lifelong bone health. We focus on reducing the widespread prevalence of osteoporosis while working to find a cure for the disease, and by supporting research and developing programmes of education and advocacy.

Find out more about our work at: www.osteoporosis.org.za

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