DRHOOK- Back story: Your vulnerable vertebrae need care

the handsome doctor John Hong of Charlottesville

"Step on a crack, Break your mother's back." You know, just because something rhymes doesn't mean it makes sense. I'll tell you what will break your mother's back: moving back into her house– when you're 40 years old! Okay, more likely osteoporosis will break your mother's (or father's) back, but what is the deal with adult children moving back home with the parents? 

 Can you give your back a break?

 Vertebral compression fractures are often due to osteoporosis. Believe it or not, two thirds of vertebral compression fractures don't hurt! So for all you know, your kids can be jumping rope on a crack, and you won't even know your vertebras are smooshing down like a marshmallow. 

 Yep, no pain– and no gain, as in height. A person's height decreases at least 1 cm with each complete vertebral fracture. So people who are "vertically challenged" like me are totally getting the short of the stick! Kyphosis ("dowager's hump") can result from the fractures and turn a person with a statuesque posture into the old witch in Snow White.

Unfortunately, once I saw a severely kyphotic man walk into a mailbox because he was too humped over to be able to see in front of him. It's hard to keep the neck hyper-extended to see forward and up. So needless to say, headaches, neck pains, and shoulder pains occur from the tense muscles. 

 Eating too many sweets can ruin your waistline, but so can vertebral compression fracture. The lower ribs can end up touching the hip bones. That would have turned Marilyn Monroe's "36-24-36" into "36-36-36." The abdominal organs are therefore scrunched and protrude forward to give a person a big belly. The ribs touching the bones can be quite painful. So much for that song, "The hip bone is connected to the– rib bone?"

 Just bending over, coughing, or picking something up can cause a vertebral compression fracture. People with acute painful vertebral compression fractures can experience excruciating pain. The pain spreads around like a girdle that is killing you. Pain can be alleviated by lying down with both the hips and knees flexed at right angles. 

 Sitting and moving make the vertebral compression fracture feel like the straw that broke the camel's back. Lifting, bending, and daily activities can be quite painful. Going downstairs can be so painful that sufferers may wish they had elevators in the house. The fracture usually takes three months to heal, and the pain lasts about four to six weeks– although up to 75 percent of victims will have chronic pain to some degree.

 An interventional radiologist can "pump you up" Arnold Schwarzenegger-style if you have a vertebral compression fracture. The procedure is called kyphoplasty. Using a needle through the skin, a balloon is inserted into a compressed vertebra and inflated. The procedure can help reduce the height loss as well as the pain. Later, cement is injected to keep that house from falling down again. The ideal advantages of kyphoplasty are faster recovery, less pain, and more functional ability. 

 Treating osteoporosis is important, with agents that include calcium, vitamin D, bisphosphonates, hormones, and PTH. Water aerobics were good enough for Esther Williams, and they're good for a person with vertebral compression fractures. Water provides a weightless milieu which is easy on the body, and exercise is important in the healing process. Avoiding dangerous activities is a good thing, like not going up ladders, jumping out of planes, or getting drunk and falling down.

 Many friends and family will bend over backwards for those they love. However, a vertebral compression fracture can really put a damper on that. Take care of your bones and stand tall.


Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice and an interesting website, drjohnhong.com. Email him with your questions.