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Osteoporosis itself does not
cause pain and there are usually no signs or
symptoms. However when fractures occur, or when
your posture changes (bent spine) due to
osteoporosis, pain can result. Pain can range
from mild to severe and can be short term,
easing as the fracture heals. Severe ongoing
(chronic) pain in osteoporosis is the result of
permanent changes in your posture and spine,
that can affect the rest of your body and how
you walk. In cases of severe osteoporosis with
multiple spine fractures, pain control may also
need to become part of daily life. An accurate
diagnosis of your condition is vital. Talk with
your doctor about your specific areas of pain.
Pain and Pain relief are very individual
problems.
Pain
in osteoporosis may be due to:
-
breaking a bone (acute pain)
-
spinal crush fractures
resulting in loss of height and change in
posture in the spine (chronic pain)
-
damage caused to joints or
limb function (as a complication of a
fracture or abnormal posture)
-
other conditions such as
rheumatoid arthritis
Coping
Strategies
Physical
Methods of Pain Management
Heat and Ice
- Heat, in the form of warm showers or hot
packs, can relieve chronic pain or stiff
muscles. Cold packs or ice packs provide pain
relief by numbing the pain-sensing nerves in the
affected area. Cold also helps reduce swelling
and inflammation. Depending on which feels
better, apply heat or cold for 15 to 20 minutes
at a time to the area where you feel the pain.
To protect your skin, place a towel between your
skin and the source for cold or heat.
- Warm towels or hot packs in the
microwave for a quick source of heat
- Frozen juice cans or bags of frozen
vegetables make instant cold packs
- Freezing a plastic, resealable bag
filled with water makes a good ice bag
Transcutaneous Electrical Nerve Stimulation
(TENS) - A TENS machine is a small
machine that sends electrical impulses to
certain parts of the body to block pain signals.
Two electrodes are placed on the body where the
person is experiencing the pain. The electrical
current that is produced is very mild, but it
can prevent pain messages from being transmitted
to the brain. Pain relief can last for several
hours. Some people may use a small, portable
TENS unit that hooks on a belt for more
continuous relief. TENS machines should be used
under the supervision of a physician or physical
therapist. They can be purchased or rented from
hospital supply or surgical supply houses;
however, a prescription is necessary for
insurance reimbursement.
Braces and
Supports - Spinal supports or braces
reduce pain and inflammation by restricting
movement. Following a vertebral fracture, a back
brace or support will relieve pain and allow the
person to resume normal activities while the
fracture heals. However, continuous use of a
back support can weaken back muscles. For this
reason, exercises to strengthen the muscles in
the back should be started as soon as possible.
Exercise or
Physical Therapy - Prolonged inactivity
increases weakness and causes loss of muscle
mass and strength. Physical therapy and a
regular exercise program can help a person
regain strength, energy, and a more positive
outlook on life. Because exercise raises the
body's level of endorphins (natural pain killers
produced by the brain), pain will diminish.
Exercise also relieves tension, increases
flexibility, strengthens muscles and reduces
fatigue. A physical therapist can help the
person reorganize their home or work environment
so that injuries can be avoided. Physical
therapists also teach proper positioning
posture, and exercises to strengthen the back
and abdominal muscles without injuring a
weakened spine. Pool therapy is one of the best
exercise techniques to gently improve back
muscle strength and reduce pain.
Acupuncture
and Acupressure - Acupuncture is the
use of special needles which are inserted into
the body at certain points. These needles
stimulate nerve endings and cause and cause the
brain to release endorphins. It may take several
acupuncture sessions before the pain is
relieved. These techniques have been used in
China especially to treat many types of pain and
as an anesthetic. Acupressure is direct pressure
over trigger areas of the pain. This technique
can be self-administered after training with an
instructor.
Massage
Therapy - Massage therapy can be a
light, slow, circular motion with the fingertips
or a deep and kneading motion that moves from
the center of the body outward towards the
fingers or toes. Massage relieves pain, relaxes
stiff muscles, and smooths out muscle knots by
increasing the blood supply to the affected area
and warming it. The person doing the massage
uses oil or powder so that her/his hands slide
smoothly over the skin. Massage can also include
gentle pressure over the affected areas or hard
pressure over trigger points in muscle knots.
However, deep muscle massage should not be done
near the spine of a person who has spinal
osteoporosis. Light, circular massage with
fingers or the palm of the hand is best in this
case.
Psychological Methods of Pain Management
Relaxation Training - Relaxation
involves concentration and slow, deep breathing
to release tension from muscles and relieve
pain. Learning to relax takes a great deal of
practice, but relaxation training can focus
attention away from pain and release tension
from all muscles. Relaxation tapes are available
to help achieve the desired effects.
Biofeedback
- Biofeedback is taught by a professional who
uses special machines to help a person learn to
control bodily functions such as heart rate and
muscle tension. As the person learns to release
muscle tension, the machine immediately
indicates success. Biofeedback can be used to
reinforce relaxation training. Once the
technique is mastered, it can be practiced
without the use of the machine.
Visual
Imagery or Distraction - Imagery
involves concentrating on mental pictures of
pleasant scenes or events or mentally repeating
positive saying to reduce pain. Tapes are also
available to help visual imagery. Distraction
techniques focus the person's attention away
from negative painful images to positive mental
thoughts. This may include watching television
or a favorite movie, reading a book or listening
to a book on tape, listening to music, or
talking to a friend.
Hypnosis
- Hypnosis can be used in two ways to
reduce a person's perception of pain. Some
people are hypnotized by a therapist and given a
post-hypnotic suggestion that reduces the pain
they feel; others are taught self-hypnosis and
can hypnotize themselves when pain interrupts
their ability to function. Self-hypnosis is a
form of relaxation training.
Individual,
Group, or Family Therapy - This form of
therapy may be useful to those whose pain has
not responded to physical agents. Individuals
often experience emotional stress as well as
depression from constantly dealing with pain.
Therapy can help one to cope with these
feelings, making it easier to deal with the
pain.
Medication
Medications are the most popular way
of dealing with pain. Medications commonly used
are aspirin, acetaminophen, or ibuprofen, and
though these are probably the safest pain
relievers available, they are associated with
gastric irritation and bleeding.
Narcotic drugs may be prescribed for short
term acute pain. These drugs should not be used
for prolonged periods because they are addictive
and can affect cognitive ability. They also have
other side effects such as constipation.
Many of those with persistent pain that has
not responded to other forms of pain relief are
treated with antidepressant medication. It has
been suggested that these drugs act in a
different way when used for treatment of
unyielding pain.
It is thought that the body's internal pain
suppression system is, to a considerable extent,
dependent upon the concentrations of various
chemicals in the brain which are increased by
the use of antidepressant. |
