Are You as Tall as You Once Were?
My mom is 5'11" according to her driver's license. Of course, she was 5'11" when she first got her driver's license. Now she is 76 and I see eye to eye with her. I'm 5'8".
Unfortunately, losing height as we get older is very common. Is gravity to blame or is there something else going on? As we age, the discs in our spine lose their sponginess and contribute to some height loss. However, if you have lost more than 1-1/2 inches, you may have compression fractures in your spine.
What are spinal fractures?
Think of the vertebrae in your spine as a stack of square building blocks with mesh interiors. Osteoporosis causes the mesh architecture inside the blocks to deteriorate, eventually causing micro-fractures. As micro-fractures accumulate, the blocks become weaker and less able to resist the stresses we expect them to handle. Many times, what seems like very minor stress can cause fractures and the vertebrae to collapse forward. This causes the vertebrae to become compressed. You may notice you are getting shorter, and gradually you will notice a curving forward of your spine. This is called kyphosis.
Spinal fractures are the most common osteoporotic fracture; over 700,000 spinal fractures occur every year in the United States alone. Spinal fractures occur three times as often as hip fractures in any one year. Spinal fractures can increase the risk of death, and unlike a hip fracture, the risk of death following a spinal fracture continues to increase progressively and not only for a limited period following the fracture. Sadly, only about one third of these fractures ever receive medical attention.
What are the causes and symptoms?
The main cause of spinal fractures is osteoporosis. Osteoporosis silently robs you of the density in your vertebrae — bones we often take for granted. Spinal fractures are particularly devastating because you often will not feel them or know they are happening until you start seeing some of their devastating effects.
Spinal fractures can occur spontaneously or from the minimal stress of day-to-day activities, such as bending forward to make the bed or lifting objects like groceries or grandchildren. While back pain can be a symptom, spinal fractures are frequently unnoticed.
Besides loss of height, some of the changes occurring in your body might be due to spinal fractures. Do your clothes not quite fit right? Are you developing a "tummy" that you never had? Do you eat less because you get full so fast? Are you short of breath from small exertions?
As micro fractures accumulate, the vertebrae in the spine may begin to collapse. What was once a nice sturdy compartment for your internal organs gradually becomes smaller and smaller, compressing your stomach, lungs and digestive track. The compression keeps your lungs from expanding fully, makes your heart work harder and your entire digestive track is pushed forward between your ribs and hips.
How are spinal fractures treated?
Sometimes extreme pain occurs with a spinal fracture. My mom experienced immediate pain last year when she twisted in the driver's seat and heard a pop. The pain lasted for several weeks, and she finally saw a spine specialist who did an MRI and recommended a minimally invasive procedure to repair the fracture. Nowadays, there are surgical procedures to treat vertebral compression fractures that can take less than an hour to perform and can be done on an inpatient or outpatient basis under local or general anesthesia depending on your doctor's recommendation. You should talk to your doctor if you have any severe back pain to see if you are a candidate for a procedure like this. However, the best thing to do is to educate yourself about your risk factors and do what you can to prevent spinal fractures in the first place by following this Protection and Prevention Checklist:
- Check your height. Since spinal fractures are often silent, the first sign that you are having fractures may be a loss of height. When the nurse puts you on the scale, ask her to measure your height as well.
- Get a bone density test. If you are over 65 (70 if you are a man), Medicare covers this simple and painless test. If you are at risk for osteoporosis or fractures, talk to your doctor about the steps you should take to prevent fractures. This plan may include medication, but it should include calcium, vitamin D and some kind of weight-bearing activity like walking. Don't leave the office without a complete plan of action.
- Know your fracture risk. You know your blood cholesterol. You know your blood pressure. You should know your risk of having a fracture, too. Go to www.americanbonehealth.org and use the Fracture Risk Calculator. Share the results with your doctor.
- Protect your spine with these tips:
- Pay attention to how you approach your daily activities.
- Avoid motions that round your spine forward.
- Always bend by hinging from your hips, keeping your back straight. Bend your knees and keep your back straight when lifting things from the floor. Practice this every time you brush your teeth and pick up the newspaper from the driveway and it will become routine.
- Avoid sudden twisting motions that torque the spine, like turning in the car to glance out the window as you back up. Support your turns with your arm and a stretched out spine.
- Pay attention to how you approach your daily activities.
- Improve your posture. Learn some simple exercises to strengthen the muscles between your shoulder blades and in your back. Practice pinching your shoulder blades together and holding for a few breathes. Roll your shoulders back, lift your chest and hold your head straight. This may feel uncomfortable for a while, but soon it will become a habit.
One thing we know about fractures is that once you have one, your risk of having more fractures increases exponentially. Please become more aware and protective of the bones that have stood up for you for so many years.