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Back Fractures and Exercises

Hi there, I'm a 48 year old male who was diagnosed with Coeliac Disease 6 years ago. I have seen a lot of people on here talking of vertebrae fractures, I wonder how these have been sustained? Is it generally by accidents or does it occur randomly without warning? I'm paranoid about every back ache I get now.

I have had 3 Dexa Scans at 2 year intervals and my spine has a T score of -3.2 and I really worried about fractures. My legs are fine due to a lot of running but there doesn't seem to be any back exercise to promote the same bone strength as the constant impact of running.

Any comments and experiences regarding back fractures and exercise would be much appreciated.

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Hi ian

You say that you have had three dexa scans in 6 years. Has your T score worsened in that time or stayed the same? A t-score of -3.2 for the spine is quite low.

Fractures can happen due to a fall or occur quite randomly without warning. Osteoporosis is often called “the silent disease” because bone loss usually occurs gradually over the years without symptoms.

Your legs will be fine due to a lot of running but whether the running is doing your spine much good is up for debate.

Perhaps seeing a physio therapist, with a keen interest in osteoporosis, may be a good idea but how you go about finding such a gem may not be so easy.

You could call the helpline and speak with a nurse about your concerns. Tel: 0808 800 0035

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Hi Kaarina, from memory I think my T score in my back has stayed the same. I expected that as my gut heals and I start absorbing calcium and other vits and minerals that it would have improved. The doctor explained that the T score is based on a 30 year old man so normally the T score will reduce with age.

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Hi ian,

I think it would be a good idea if you gave the helpline a call and spoke with a nurse. :)

From August 1st 2015, calling the telephone helpline on 0808 800 0035 is free from all UK landline, mobiles.

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Hi ian

Here is a link to an exercise to strengthen the spine saveourbones.com/osteoporos...

I hasten to add, I have not done this exercise and I would not advise anyone to try until they have discussed this with their doctor.

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Thanks for your link Kaarina, I'll take a look!

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That you for your post. I too would like to know some good spine strengthening exercises. I have found the exercise from 'Save our bones' kindly posted by Kaarina to be good but would like to know some other ones as my neck isn't great. I can't believe there aren't standard spine exercises out there as they are so needed. Btw I would have thought running would also be good for your spine though not treating it directly.

Good luck

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Hi Katy, it is so difficult to find the correct exercises to do when diagnosed. What suits one person, will not be good for another person. It is very individual, finding specific exercises that will be of benefit to us personally. Ideally, finding a physio/trainer who has a real interest in osteoporosis would be great. Some of us have other conditions as well as OP that can make it even more difficult to know what spine strengthening, exercise, for example, to do.

We all know walking, tai chi, pilates, yoga are suggested but that is a bit vague. I would have difficulty with yoga and pilates now if it is mat work. ;) I have a very problematic shoulder, for example. ;)

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Hi Kaarina, yes I agree about us all having specific needs. However I do think there should be a standard list of exercises for people with osteoporosis focusing on different parts of the body. We all know our specific needs and could choose and tailor the exercises accordingly. I personally much prefer to try exercises at home and take it really slowly rather than working with a physio who doesn't understand all the subtleties and intricacies of my other ailments/conditions.

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Katy, There are lots of spine strengthening exercises for the spine if you google.

for example

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Thank you Kaarina, that's so kind and helpful of you, I will check them out.

All the best

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Is this one any good, Katy?

Over and out, I am off to visit my dear MIL in hospital who is 98 years old (no dx of OP).

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Thank you so much I really liked the video and I'm looking forward to trying them ,it helps to know what I can do without making my condition worse ,I'll leave the push-up ones for now but good to know I can strengthen & help my bones and posture x

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Hi Onlymary,

You're welcome. :)

NOTICE: Please check with your doctor before beginning this or any exercise program.

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Hi Kaarina. I just had a look at these exercises, they look really good and I will definitely give them a go. Also the bit about posture was so helpful, I didn't realise the importance of good posture. Thank you very much.

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if you watch this you will see how she keeps her back supported while doing the exercises. You want to be sure not to have your back taking the weight while you are bent forward (basic physics of leverage). I thought these exercises made sense.

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It's really important that you bear this in mind for everything you do, not just when exercising. As far as your back is concerned, it's best to support yourself in the most minor of tasks, eg leaning forward when cleaning your teeth, I know to my cost how easy it is to break bones while doing trivial. This has had to become a way of life for me.

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Hi, interesting to hear your comments. My spine T score was -3.2, and Z score -2.9 but I don't really take much care to protect back, just do the same as I always have. Do you mind me asking what your T/Z score is and how old you are ? I can't believe that such little things could cause fractures. Did you see a specialist when diagnosed as I haven't been offered any support other than the prescribing of AAcid?

Thanks.

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Hello Ianwoowoo

I only found out that I had osteoporosis after fracturing, so my experience is probably different from yours. I had bronchitis and fractured a vertebra from coughing - although at the time, I thought I'd pulled a muscle and so did my GP. During the summer of 2015, I thought I kept aggravating that pulled muscle. It turns out I was fracturing more vertebrae. The things that did it were: leaning forward in the garden to deadhead flowers, leaning forward to clean up cat sick, leaning forward to wash my feet in the shower. As I hadn't been diagnosed then, I continued to exercise and I think I probably hindered the healing process of existing breaks. I saw a consultant privately after 6 months of pain and an MRI revealed that I had fractures in all my lumbar vertebrae. One was significantly older than the others, so was probably the cause of my periodic back pain going back over several years. I have had vertebroplasty in the damaged vertebrae but am still very careful when I exercise and generally. (I always was but the coughing was something I didn't have a strategy for!) I didn't have a DEXA scan until after the vertebroplasty procedure so don't know what the score was for my lower spine. My hips were -2.4, which is not too bad. I assume my back was worse though. But as I keep reading, fractures and low DEXA scores don't always correspond. I am having another DEXA next February, so it will be interesting to see where I am with bone density. I am hoping that they will scan my thoracic spine as they can't do the lumbar.

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Blimey - sounds like it's a tricky thing to identify in the first place. I have had nuisance back problems for years too and worry now that it may be more than a back ache. Need to start thinking more seriously about posture and taking card when I'm doing things around the house and garden. Thanks for your feedback - good to know all this stuff.

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Yes posture is really important. I try really hard to keep upright, shoulders back. It's harder when you have wedge fractures as there's a tendency for the body to lean forward! But if you do, it puts a lot more pressure on the vertebrae - which is pretty much what we want to avoid. That's why the forward bending exercises in things like Yoga are not recommended. If you need to bend forward, bend at the hips and knees - never at the waist. Apparently, that is a western habit - I saw a photo of ladies in the paddy fields all bending beautifully straight backed and hinged at the hip! Prevention is far, far better than cure, so start your good bending habits now Alanwoowoo!

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Shoulders back when running, ianwoowoo. :)

One of my shoulder exercises from a physio post op total shoulder replacement is to look in the mirror and to pull the shoulders back, whilst imagining tucking each shoulder blade into the opposite back pockets of your jeans and count to five. Repeat 10 times. A lovely shoulder stretch. :)

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I've looked into building spine bone density as mine is low. My understanding is that a lot can be done to improve your spine providing you havent already got compression fractures. Simple things like standing on your toes and dropping your heels (easy to add into your life when waiting for kettle to boil etc), hopping, walking with a weighted vest, specific yoga exercises that load the bone without the strain of too much bending foreward unsupported or backwards, and also I read a study last week of the prone exercise where you raise your head and shoulders from the floor a little bit but have weights in a high-up -your back back pack. Gradually increase weights as you increase in strength. All of these increase bone density of the spine as they load the bone. Just be careful and pay attention to posture and extent of spine bending.

Good posture is important in everyday activities as well as when doing the exercises. I wore a lumolift (small device that warned me when I wa slumping) for two years when I first got diagnosis to increase my awareness of my back posture.

After a couple of years with a lot of anxiety and other health issues associated with my original wrist frature (including severe side effects from the osteoporosis meds - depression) I am now getting back to be enthusiastic whilst careful. Stress is really bad for bones, so being cheerful and feeling in control are great things to work towards.

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Hi Lois,

Do you take any meds now. I know you were on AA for a while. I'm not on any meds at the moment, but still not sure if I've made the right decision. My heads still all over the place with this diagnosis. I've had a wrist fracture like yourself.

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I thought about it a lot and did a lot of research. I'm not convinced by the mechanism for adding bone density - seems you could slow down bone destruction and just end up with heavier bones that weren't necessary stronger, just as if you fixed a potholey road by adding new tarmac on top without fixing the underneath surface. I thought about HRT, and if I decided I really needed something I'd try that. Trouble is, every medication I've been prescribed (including the AdCal and even the titanium pate in my wrist) gave me awful side effects, so reluctant to try anything else.

exercise does work, and avoiding falling over works (improving fitness and balance is something everyone can work on). I looked for studies that assessed the social and psychological impact of an osteoporosis diagnosis, and ones which fully assessed the impact of the meds and the differences between those who took them, those who didn't, and those who stopped. Nothing much is available. I was going to do a PhD on this but cancelled as felt too rubbish, now I know it was the AA making me very depressed, and the titanium plate which, since its removal has not only allowed my thumb tendon to stop snagging and getting worse all the time, but I now feel like I'm getting my brain back.

Also, if possible, avoid antacids and medicines like Omeprozole, bad for bone density, avoid stress (I know thats hard, but when my husband gets stroppy with bad drivers I hold up my hand and say- no stress, bad for my bones. Had a very difficult time with family issues over the last five years, and that cant have helped me, so being cheerful is important. SInging in a choir helped - I could do that with a bad wrist, and found one where anyone could join- all these things help you feel socially engaged and improve a lot of psychological markers. Take Vit D, especially in the winter. Helps with the mood too.

So, with the exercise, be careful, do the research, if you have someone who could watch you while you learn to make sure you are doing it right that would help, but I think this is the best way for me at the moment. Lots of people in the phys ed system dont have a clue about caring for a fragile back so you need to be confident in being clear what you need for your own safety.

Hope this helps, just my opinion, but now that Ive decided I feel comfortable with my decision.

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You sound very positive about it all. I'm still so confused and shocked at the moment. And afraid if I'm honest. I've upped my calcium intake and have stopped taking omeprazole so I'm hoping that will help. And also walking lots, starting tai chi and Pilates and hoping to start a dance class. I'd love my scores to improve naturally but wondering if I'm just living in cloud cuckoo land.

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I've been coming through this for about three years, only just getting past the impact of the diagnosis and confusion. I figure its not uncommon to take a couple of years to get used to a new state, like a bereavement. Since I took the adcal I cant even take calium supplements, which I had done every day since my early twenties. They gave me a feeling of jet lag and not knowing where my feet were.

be careful with the degree of back bend (both forward and backward) with pilates and yoga. There are some good books. I like Yoga for osteoporosis by Loren Fishman and Elen Saltonstall, they are doing serious research on the effect of their programme too.

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Hi debbietilbee. I'm in exact,y the same place as you. Newly diagnosed after coming through cancer, frightened of meds, upping the walking, enrolled in dance class, buying supplements, waiting for Gp and nurse appt for bloods etc. Careful with diet. Physio sent me NHS booklet with advice and exercise as have to wait 10 weeks for appt with her. Don't want to take meds but what if natural approach doesn't work?

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Hiya, it's really difficult to know whether your chosen regime is working when you only get scans every 2-3 years isn't it! If only it was as easy as checking your blood pressure.

Like most people I'm not keen on taking medication but have started on AA and so far haven't noticed any drastic side effects but who knows what it's really doing to me. All I know is that I have been a keen runner for many years and even with lots of miles a week it hasn't improved me spine results, so I do question why people think walking is going to make much difference? Weighted or not surely the impact is going to much lower therefore won't promote the same bone response.... any thoughts?

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Ianwoowoo,

runnersworld.com/injury-tre...

A bit of bed time reading perhaps? Not sure if it answers your question though......

In the end, there is not enough known about OP and we are the guinea pigs and have to decide for ourselves what type of exercising may or may not suit us personally. As we also decide if to take medication or not and if to add certain supplements to our diet.

This article is 12 years old but still worth reading in my opinion, especially if you are a runner.

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Hi, have just been talking to someone from the NOS helpline and she told me that the DXA is only half the story and its more important to build bone strength. Which is what we should be able to do if we exercise well and take supplements and eat carefully with plenty of calcium.

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and I like the information from this site

betterbones.com

betterbones.com/exercise/ne...

dont know why they arent making links, but lots of information from Dr Susan Brown and a very pragramatic and informed approach

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Ian,

Have you done the FRAX test: sheffield.ac.uk/FRAX/tool.jsp to calculate the ten year probability of fracture with BMD?

Mine was calculated and the result was in my DEXA report. My 10 year probability of a fracture risk based on FRAX was a 13% risk of major osteoporotic fracture and 0.9% risk of hip fracture alone.

As both these figures were below the recommended treatment threshold according to NOGG guidelenes, no treatment was recommended and the OP medication I was on could be discontinued. I did not wish to discontine my OP medication.

I asked my GP if I could be referred to see an OP specialist and actually now see the doctor who wrote my DEXA report! On chatting to him about my medical history he changed his mind and he agreed I should be on medication.

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No I have not heard of this. I'll investigate but I'm sure there was no mention on my DEXA report. Thanks for the info.

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If there is no mention of it on your DEXA you can work it out yourself.

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Thank you Kaarina and LoisParker for your comments and recommendations, all really helpful. I've bookmarked the exercise videos on my computer and will try to make time to fit them into my routine! I've been going to a pilates class, but although it's a beginners class and the instructor was giving me alternatives to flexion exercises, I've still found it putting too much strain on my muscles - I have enough aches and pains without adding to them! So after about 10 weeks I've decided to give it a miss, which means these posts have been very timely!

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Hi Met, thank you, you're very welcome if I have helped in any way. I know the feeling about having enough aches and pains without adding to them. You gave the pilates class a good run if you continued for 10 weeks. I wish you well, look after yourself and let us know how you get on. :)

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I watched quite a few videos on YouTube by Margaret Martin on osteoporosis exercises that I found to be informative.

This is one of them:

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Hi Ian sorry to hear that but I thought I would tell you that I have 4 fractured Ribs and Smashed vertebrae I banged my back off a hand rail in work just thought I was winded for 6 weeks I carried on working pain got so severe that I went to the doctor and she sent me for an x ray which showed the fractures 20 months later still in pain constantly had a dexa scan a month ago and I was diagnosed with osteoporosis and Osteoarthritis double whammy I'm 50 years old and the body of a 75 year old I'm going for physio you should speak to your doctor about it well l hope you are pain free soon x

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Wow - sounds terrible, sounds like breaks can occur so easily, do you know what your T score was for your spine ?

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Spine tscore-3.200 zscore - 2.300

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I will get my letter from hospital when my daughter goes to school 10 minutes x

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