Osteoporotic pelvic fracture

[MKari]

Hello,

I would really appreciate some guidance regarding my mom's condition. After years of taking corticosteroids for an autoimmune condition and being diagnosed with osteopenia, she had a nasty fall on the ice in January 2022 which left her with an unstable pelvic fracture, compressed lumbar spine disks and a pubic fracture. Unfortunately, during the initial CT scan they only saw the pubic fracture, not that the entire pelvic had breaks and told her it's enough to stay off her feet for a month after which to slowly start moving around. Paid meds were prescribed and that was it.

When the pain continued after several months, we did a second CT which showed the pelvic fracture but every ortho that we've talked to says that it's too late for any surgeries and it will heal on its own. What followed was 2 years of pain during which it did but of course, due to the lack of treatment it didn't heal right...We've talked to so many doctors who say that the fractures are healed and they don't understand why she is hurting but the pain continues and at points it's so bad, she starts crying She is mobile but limping from these fractures and due to the combination of paid meds and antidepressants prescribed to her for the pain + the stress of the constant pain, she develop a heart issue - Takotsubo Cardiomiopathy that was nearly fatal (literally 5 minutes delay getting to the ER and she would have been gone...:().

I really need some advice on how to help her at least have some relief. Due to the heart issues, even though they are under control right now, they stopped almost all of the pain meds and antidepressants and right now, she is trying gels and taking Paratramol but even that doesn't help the pain sometimes. She seems to have times when it's not that bad and then times when she's in immense pain, especially the pubic bone area and after 2 years she feels like it's worse than in the beginning when she originally had the break, which is insane to think about. Of course, what worries me maybe the most is that her heart may bring more issues because of this constant pain...

Please help me with some advice. Besides surgical options which I'm not sure if they won't make things worse at this point, are there other things we can try? She has tried physio and it did help a bit, but she stopped after the heart issues because it needed time to heal properly. Is there a minimally invasive procedure that we could ask the doctors about that could potentially help? Any meds or exercises ...literally anything that could be of help! At this point, we are willing to try almost anything to have any relief for her.

P.S. We're in Eastern Europe, so we have more limited options but I will find a way.

[Fruitandnutcase]

I really feel for your mother. You don’t say how old she is but I fractured my sacrum four years ago when I was 72. It was agony to say the least and worse still it was around the time of covid so getting treatment was difficult, my GP surgery had been bought out and all the doctor left so there was no one there who knew me and the person I spoke to refused to send me for an x-Ray saying ‘at my age I probably just had a touch of osteoarthritis!’

I ended up going to our local hospital where a lovely young doctor said he thought I had sacroiliitis which although it wasn’t right was a good guess. He gave me painkillers and booked physiotherapy for me.

In the end I saw a physiotherapist privately, he referred me for a private MRI scan which was followed up by a second pelvic MRI scan.

In my case it was just a case of good pain relief and gentle exercise. I couldn’t take the painkillers I was prescribed and ended up just taking paracetamol every four hours, sometimes with ibuprofen in between.

I had an elderly friend who was a keen cyclist and who fractured her pelvis when she had an accident and she was just left to heal - that was the first time I had heard if that so I wasn’t surprised that I was left to my own devices.

I read something online about PEMF therapy and bought myself a pulsed electro magnetic frequency mat and used to lie on that every morning and evening and that made an enormous difference to me.

Unfortunately since buying mine they have pretty much doubled in price plus you need to be able to lie on your back at floor level and there are some contraindications to using them so it is something you would really need to investigate.

Gentle exercise and good physiotherapy are what helped me most so it would maybe help if your mum could find a good physio experienced in working with people of her age and in her condition. My Pilates teacher is a physiotherapist and she is wonderful. I also use Nordic walking poles when I am walking, it is worth finding someone to teach you how to use them correctly. They take the weight off your knees and pelvis which makes a big difference, plus they help you to balance.

Could your mother have had another fracture in this area? That would explain why she is saying it is as bad as it was when she first fractured.

Is it nerve pain your mother is getting? Apart from the fractured sacrum my spine is generally in a bit of a mess and I started to get horrible, sharp nerve pains. Eventually when it got really bad I saw a physiotherapist who taught me a couple of very simple exercises to keep it at bay and knowing I can do that myself has made a big difference.

If it is any help, I thought I would end up having to buy a mobility scooter, I was in a lot of pain and couldn’t see me ever getting back to how I used to be, I’m not exactly how I was before I still take paracetamol every now and again and use rub on gels - and self heating pads that I can stick on especially if the weather is cold but I’m still going for reasonably long walks and I’m nowhere near needing a mobility scooter. Good luck to you and your mum, I hope you can find an answer.

[MKari in reply to Fruitandnutcase]

Thank you so much for your answer and I'm so sorry that you went through this, those types of fractures really are something else! My mom is 57, so still relatively young and that's what makes me hopeful that despite her medical problems, we can find a solution to at least improve her condition.

Thank you for the advise, it does reinforce my thinking also that more physiotherapy and exercise could be of benefit to her (she always seems to worry that if she moves more than she does now - which is not that much due to her pain, it will cause another break). Thankfully, there haven't been new breaks since then, we have had CTs every couple of months because we were always trying to find out why she was still having pain (they showed "calcification" of the fractures). Magnet therapy for some reason made her worse... they did it during her first physiotherapy (it was like 1 week though, so not a lot to make a difference) and while she initially felt better after, it seemed like after a couple of weeks, it made the pain worse. I don't know why, everything I've seen shows that people benefit from it and with her, it was the opposite..

I will definitely look into these options and thank you so much for your advice!

[Fruitandnutcase in reply to MKari]

Ah, tell your mum she has youth on her side. She doesn’t want to go mad exercising but if her scans are looking good then moving will help. I walk for an hour every day. When it first happened we used to go to a local nature reserve which was totally flat and had benches at regular intervals and it took me all my time to reach the first bench. Now I can go right round without stopping - it’s not far really about 5000 steps.

At the beginning I found if we met anyone we knew and stood still to chat, standing still was very unpleasant which was where the Nordic poles helped. I could kind of lean on them for support.

Such a pity the magnet mat didn’t work for her. Over the years for my other spinal problems I’ve tried all sorts of things and TENS which a lot of people like did nothing for me, I still had the pain and I also had a really ittitating tiny electric shock, I’ve tried accupuncture and that didn’t help either. I did have some massage last summer by the physio who gave me exercises for the nerve pain and that felt good but short.y after I fractured my sacrum the physiotherapist who organised nt MRIs did some very gentle massage and I didn’t like that at all. Moving is what helps me.

The thing is your mum should not to anything that causes pain, our Pilates teacher always says ‘remember, don’t do anything if it hurts, not even if I’ve told you to do it and even if it’s something that you’ve done before.

I have a nice rocking stool that I bought many years ago long before I fractured my sacrum and which I find comfortable to sit on but I would say to try it before you think of buying one. At that point I used to either have to stand up or lie on the floor and I got fed up lying on the floor with two little boys and their friends running about around me and found something I was comfortable sitting on.

ergonomist.co.uk/products/e...

Have a look at this lady’s website. She is a Canadian physiotherapist and the site is full of all sorts of very sensible information, I feel very comfortable with what she has to say. melioguide.com

[MKari in reply to Fruitandnutcase]

Thank you so much for the guidance, I will relay all of this to her! And will definitely try to find a good physio to help her, but I think it will give her confidence to let her know what helped someone in her shoes. About the magnet therapy, I won't rule it out completely yet, as it could be just a coincidence that she felt worse a few weeks after...really, she can't tell what the trigger is with some of the exacerbations, so it could be something else entirely. I hope so, at least it's another thing we can try.

Massage didn't help her either, I think it might have done more damage because it was more like manual therapy...but it was a long time ago at least.

Thank you so much for the Canadian physio's website, I will definitely take a look! Hopefully, we can find something that works for her too to at least have some relief. I really appreciate you sharing your story, I should have tried to talk to other people suffering similar issues sooner, especially seems like it's not such a common injury