You have just been told you have one or more vertebral compression fractures in your back, and you are wondering if walking and sitting can make things worse or is it beneficial?
In this article I will be answering some of frequently asked questions about walking and sitting when you have a vertebral compression fracture
As a diagnostic radiographer I see so many patients who come for x-ray with vertebral compression fractures.
And as always I have delved into scientific medical studies to answer your questions, references at the end of the article.
Happy reading!😀
Have any questions, remarks, or experience to share? Feel free to use the comments section at the end of the article!🙏
Last updated: Oct 2024. Written by Juliet Semakula, diagnostic radiographer.
Disclaimer: no affiliate links.
summary :A vertebra compression fracture in the spine does not always need surgery. so, in certain cases, yes, you can walk with a broken vertebra.
▶️Is walking good for a vertebral compression spine fracture?
Walking with a vertebral compressed spinal will depend on optimal benefits for everyone.
It will depend on the type of compression you have, your medical history, health status, preferences, and priorities.
If after seeing a specialist and given approval, YES, you can walk with a broken vertebra, because remaining entirely inactive until the fracture has healed can be counterproductive.
Sometimes bed rest will be recommended for a few days after you have a compression back fracture.
If your vertebral fracture is stable, the doctors may recommend a combination of low-impact exercises such as standing up to walk after you have been sitting for a long time.
This will allow you to stay active, while reducing the pain at the same time. Remember physical activity helps strengthen bones and maintain the stability of the spine.
Walking short walks when you can is better than just staying in bed because it helps minimise the chances of developing blood clots or deep vein thrombosis in the legs.
Also, low-impact activities, such as walking at a gentle pace are good for the heart. A healthy circulatory system can increase blood flow to the fracture and help that fractured bone heal more quickly.
I have seen patients in x-ray walking after they have been told they have a vertebral compression fracture. And some of them did not even feel pain at that moment.
▶️What do the general recommendations say about walking after a vertebral compression fracture?
⏭️The arguments for:
There was very little research about advice on walking after a vertebrae compression fracture. A few publications had this to say.
Resuming walking immediately after a spine (back fracture) would be a good thing because it helps to:
Maintaining muscle strength may prevent loss of functional dependence.
People with vertebral fracture or multiple low trauma fractures should try to walk only up to an impact equivalent to brisk walking (Brooke 2022)
If you are at risk of falls you can start with targeted strength and balance training before you start to walk.
There is little evidence that physical activity is associated with significant harm, and the benefits, in general, outweigh the risks.
⏭️The argument against
Vertebral compression fractures are among the most common fragility fractures caused by osteoporosis.
Walking is not recommended in some elderly patients because of the fear of falling. Safety and related impairments will require consideration before walking.
Walking can exert too much stress on the fractured area and ligaments, increasing the risk of improper consolidation and healing.
According to some study medical recommendations, strict bed rest after vertebral compression was advised. They relied on low-quality evidence to make this recommendation (Parreira 2017)
According to the National Institute for Health and Care Excellence Guidelines (United Kingdom, 2013).
The bed rest duration was approximately 6 weeks, pending a follow-up X-ray before you can start walking again.
However other studies recommend resuming walking immediately after a compression vertebrae fracture.
▶️How to walk with a compressed vertebra in your back if walking is permitted?
When you have had your x-rays and got your diagnosis, your doctor should have given you clear information on whether it is ok to walk or rest.
You won’t be able to walk if the fracture damages your spinal cord enough to make you paralyzed.
When you are advised to walk:
When walking, keep in mind that doing it with correct posture is the way to be sure your weight is distributed correctly, and this is how you can prevent overloading certain areas of the spine:
When walking you should try to:
🟤Contract your abdomen slightly to protect the lower back.
🟤Hold your shoulders back, so that your back is naturally straight.
🟤Try to walk when you can, there is no set distance or time you need to walk.
🟤Walk at a steady pace.
🟤Wear comfortable, lightweight clothing.
It is important to pace your activity as you recover from your fracture to help keep your pain level balanced.
Often, you’ll require a walking frame, crutches, or a walker to alleviate back pain
▶️How to resume walking after a period of bed rest?
When you have been bedridden without weight-bearing for several weeks or months since your spine fracture it can be difficult in the beginning to just get up and walk.
You will need assistance to get out of bed by a trained person for at least a few sessions. The idea is to gently reacclimate your body to two positions.
🟡To be upright
🟡To move.
For your first time standing after an extended period of bed rest, follow these steps:
♦️Sit for a few minutes (if you have been strictly lying down for several weeks).
♦️Then, stand up with a sturdy support, and have someone nearby in case you experience any dizziness from being upright for the first time.
Resuming walking with support
When resuming walking with support, it should be done gradually based on your feelings and any pain you may experience.
You will likely need a walker or crutches for at least a few days. You can increase the distances you walk over the days, starting on flat surfaces and then including uphill and downhill walks.
You can also tackle stairs, as this engages your muscles and cardiovascular system differently.
If you experience pain during the night or the day after, adjust your activity levels. Reduce your activity slightly the next day, and then gradually increase the frequency or intensity in the following days.
▶️How long does it take to walk normally after a vertebral compression fracture?
I have seen some people walking comfortably within 2 to 3 weeks. While others may require 1 to 2 months to return to a normal walking pattern, but rarely more.
In cases of multiple vertebral compression fractures partly due to osteoporosis, long-term changes in walking may occur.
Here are some additional insights from studies that track the recovery of individuals who have experienced vertebral compression fractures.
People who have had one or more osteoporotic vertebral compression fractures often experience altered walking patterns for over 6 months compared to people of the same age without fractures:
They make shorter steps, quicker, and more spread out. However, improvement is possible, and a return to a normal walking pattern can be achieved (Jacobs 2020).
Another study observes that walking is slowed down in women with at least two vertebral compression fractures compared to those without fractures, but not in those with only one (Arima 2017).
▶️How should you sit with a broken vertebra?
Most fractures of the spine occur in the thoracic spine (middle part of the back) and lumbar spine (lower back) or the point where they meet (thoracolumbar junction).
It is important to use the right position when sitting when you have been diagnosed with a vertebrae compression fracture.
Steps:
1️⃣Make sure that the chair where you are going to sit is stable and does not move.
2️⃣When you sit, place your feet about 15 cm apart from each other.
3️⃣Make sure both soles of your feet are flat on the ground.
4️⃣Keep your back straight at a 90-degree angle.
5️⃣Avoid crossing your legs.
Change your position regularly, ideally about every 20 to 30 minutes as this will help to prevent too much stiffness building up in your back. For example, stand up beside your chair for a few seconds.
We have come to the end of this article; hope I have given you some reassurance. Wishing you a quick recovery!🙋
📚Sources:
Brooke-Wavell K, Skelton DA, Barker KL, Clark EM, De Biase S, Arnold S, Paskins Z, Robinson KR, Lewis RM, Tobias JH, Ward KA, Whitney J, Leyland S. Strong, steady and straight: UK consensus statement on physical activity and exercise for osteoporosis. Br J Sports Med. 2022 May 16;56(15):837–46. doi: 10.1136/bjsports-2021-104634. Epub ahead of print. PMID: 35577538; PMCID: PMC9304091.
Kaizu Y, Tamura S, Iwamura T, Saito S, Kobayashi S, Takeda R, Iwamoto H, Miyata K. Development and validation of a clinical prediction rule for walking independence in hospitalized older adults with a vertebral compression fracture. Physiother Res Int. 2024 Oct;29(4):e2117. doi: 10.1002/pri.2117. PMID: 39101274.
Parreira PCS, Maher CG, Megale RZ, March L, Ferreira ML. An overview of clinical guidelines for the management of vertebral compression fracture: a systematic review. Spine J. 2017 Dec;17(12):1932-1938. doi: 10.1016/j.spinee.2017.07.174. Epub 2017 Jul 21. PMID: 28739478.
American College of Sports Medicine; Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, Minson CT, Nigg CR, Salem GJ, Skinner JS. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc. 2009 Jul;41(7):1510-30. doi: 10.1249/MSS.0b013e3181a0c95c. PMID: 19516148.
Jacobs E, McCrum C, Senden R, van Rhijn LW, Meijer K, Willems PC. Gait in patients with symptomatic osteoporotic vertebral compression fractures over 6 months of recovery. Aging Clin Exp Res. 2020 Feb;32(2):239-246. doi: 10.1007/s40520-019-01203-9. Epub 2019 Apr 27. PMID: 31030421; PMCID: PMC7033073
Arima K, Abe Y, Nishimura T, Okabe T, Tomita Y, Mizukami S, Kanagae M, Aoyagi K. Association of vertebral compression fractures with physical performance measures among community-dwelling Japanese women aged 40 years and older. BMC Musculoskelet Disord. 2017 Apr 28;18(1):176. doi: 10.1186/s12891-017-1531-3. PMID: 28454529; PMCID: PMC5410022.