Along the spine, women buckle at breaking points
An 80-year-old friend was lifting a corner of the mattress while making her bed when, as she put it, "I broke my back."
In fact, she suffered a vertebral fracture — a compression, or crushing, of the front of a vertebra, one of the 33 bones that form the spinal column. This injury is very common, affecting a quarter of postmenopausal women and accounting for half of the 1.5 million fractures due to bone loss that occur each year in the United States.
By age 80, two in every five women have had one or more vertebral compression fractures. They often result in chronic back pain and impair the ability to function and enjoy life. They are one reason so many people shrink in height as they age.
Multiple vertebral fractures, found in 20 percent to 30 percent of cases, often result in a hunched posture, a condition called kyphosis that impairs breathing and compresses the abdomen, leading to a protruding stomach with limited capacity.
But while vertebral fractures are a telltale sign of bone loss among women over age 50 and men over age 60, most who suffer them are unaware of the problem and receive no treatment to prevent future fractures in vertebrae, hips or wrists, the bones most likely to break under minor stress when weakened.
Yet, if a vertebral fracture is diagnosed and properly treated, the risk of future fractures, including hip fractures, is reduced by half or more, studies have shown.
"Most vertebral fractures do not come to medical attention at the time of their occurrence," Dr. Kristine E. Ensrud and Dr. John T. Schousboe wrote recently in The New England Journal of Medicine. One reason is that the pain may be minimal at first or, if more severe, attributed to a strain that subsides over a few weeks.
Indeed, patients or their physicians are made aware of these fractures in just one-fourth to one-third of the instances in which they are discovered on X-rays, according to the doctors.
"The patient may have had a chest or back X-ray for some other reason, perhaps to rule out pneumonia, but the focus is on why the test was ordered, and an incidental finding of a vertebral fracture is ignored," Ensrud said in an interview. "Doctors need to be more aware of this problem, and maybe patients should ask to see the report."
Ensrud, an internist and epidemiologist who researches osteoporosis at the University of Minnesota and the Veterans Affairs Medical Center in Minneapolis, noted that in a person with severe osteoporosis, a vertebral fracture can be caused by something as mundane as coughing, sneezing, turning over in bed or stepping out of a bathtub.
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Indeed, patients or their physicians are made aware of these fractures in just one-fourth to one-third of the instances in which they are discovered on X-rays, according to the doctors. "The patient may have had a chest or back X-ray for some other
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She couldn't bend her left knee, and kept it elevated. A meniscus repair surgery didn't alleviate the pain. An X-ray showed that the cartilage in her left knee was gone. It was bone on bone. Dieball opted for surgery that would replace her knee with a
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