SPINE STRESS-FRACTURE, NECK OR BACK |
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General Information
DEFINITION--A hairline fracture of the spine in the neck or back (cervical, thoracic or lumbar spine) that develops after repeated stress. A stress fracture is sometimes called a FATIGUE fracture. X-ray changes may not appear clearly for several weeks after pain begins. The X-ray appearance may be similar to a bone tumor.
BODY PARTS INVOLVED
Any segment of the spinal column in the neck or back.
Any joint connecting segments of the spinal column.
Soft tissue surrounding the fracture site, including muscles, nerves, tendons, ligaments, periosteum (covering to bone), blood vessels and connective tissue.
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SIGNS & SYMPTOMS
Severe pain in the neck or back following injury.
Swelling and bruising of soft tissue around the fracture.
Tenderness to the touch.
Warmth over the fracture site.
Numbness beyond the fracture site (sometimes).
CAUSESDirect or indirect stress to the bone. Indirect stress may be caused by twisting or violent muscle contraction.
RISK INCREASES WITH
Contact sports such as football, wrestling, boxing or soccer.
History of bone or joint disease, especially osteoporosis.
Obesity.
Poor nutrition, especially insufficient calcium and protein.
If surgery or anesthesia are needed, surgical risk increases with smoking and use of drugs, including mind-altering drugs, muscle relaxants, antihypertensives, tranquilizers, sleep inducers, insulin, sedatives, beta-adrenergic blockers or corticosteroids.
HOW TO PREVENT
Build your strength with a good conditioning program before beginning regular athletic practice or competition. Increased muscle mass helps protect bones and underlying tissue.
Ensure an adequate calcium intake (1000mg to 1500mg a day) with milk and milk products or calcium supplements.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's diagnosis and care.
Physical therapy and rehabilitation.
Self-care during rehabilitation.
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and physical exam by a doctor.
X-rays of the neck and back.
POSSIBLE COMPLICATIONS
Pressure on or injury to nearby nerves, ligaments, tendons, blood vessels or connective tissues.
Complete fracture and spinal-cord damage from continued activity after symptoms begin.
Problems arising from plaster casts, splints or other immobilizing materials. See Appendix 2 (Care of Casts).
Arrest of bone growth in young people.
Unstable or arthritic joint following repeated injury.
PROBABLE OUTCOMEIt is impossible to predict exactly how long a fracture will take to heal. Variable factors include age, sex, previous health and general conditioning. The average healing time for this fracture is 6 to 8 weeks. Healing is considered complete when there is no pain at the fracture site and when X-rays show complete bone union.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AIDNone. This fracture develops gradually and does not require setting. The fractured bone is not displaced.
CONTINUING CARE
Immobilization will be necessary, usually with a cast or corset.
After cast removal, use frequent ice massage. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball. Do this for 15 minutes at a time, 3 or 4 times a day.
Apply heat instead of ice, if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments and ointments.
Take whirlpool treatments, if available.
Massage gently and often to provide comfort and decrease swelling.
MEDICATIONYour doctor may prescribe:
Narcotic or synthetic narcotic pain relievers for severe pain.
Stool softeners to prevent constipation due to inactivity.
Acetaminophen (available without prescription) for mild pain after initial treatment.
ACTIVITY
Actively exercise all muscle groups not immobilized. These muscle contractions promote fracture alignment and hasten healing.
Resume normal daily activities gradually after treatment.
Begin reconditioning and rehabilitation after clearance from your doctor.
DIETDuring recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.
REHABILITATIONBegin daily rehabilitation exercises when movement is allowed. Use ice massage for 10 minutes prior to exercise. See section on rehabilitation exercises, depending on the area of injury.
CALL YOUR DOCTOR IF
You have symptoms of a spinal stress-fracture, especially unexplained persistent numbness or pain in the neck or back.
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