How a back brace can help patients with osteoporosis

Osteoporosis is a progressive condition that weakens bones, making them fragile and more likely to break.

As a result of this loss of bone, many osteoporosis patients will also suffer spinal compression fractures, with 1.4 million new clinical vertebral fractures reported in the year 2000.1 Such fractures can have a serious impact on a person’s ability to maintain an active lifestyle, with pain and a loss of confidence presenting two formidable challenges to overcome.

One therapeutic option available to osteoporotic patients is semi-rigid back bracing. These kinds of medical orthoses are designed to alleviate the symptoms of vertebral osteoporosis and help patients stay active, but what evidence is there that these products work?

What causes osteoporosis?

Bone naturally becomes thinner as a person ages, but women are especially vulnerable to osteoporosis after the menopause because their ovaries no longer produce oestrogen hormones which help maintain bone mass. Around 200 million women worldwide are estimated to be affected by osteoporosis.

Other causes of osteoporosis are:

• Removal of the ovaries
  
• A diet lacking sufficient calcium
• Certain hormonal disorders
• Prolonged use of corticosteroid drugs
• Prolonged immobility

Osteoporosis is also more common in heavy smokers and drinkers.

What are the symptoms and signs of osteoporosis?

The first sign of osteoporosis is often a fracture caused by a fall that would not result in a fracture in a young adult. Typical sites for such fractures are the wrist and the top of the femur.

Another type of fracture that occurs in osteoporosis is a spontaneous fracture of one or several vertebrae, which causes the bones to crumble, leading to a progressive loss of height or to pain due to compression of a spinal nerve.

What are spinal compression fractures, and how are they treated?

Spinal compression fractures occur when the combined axial and bending loads on the spine exceed the strength of the vertebral body, resulting in the collapse of the vertebrae.

These fractures are associated with back pain and disability, loss of height, and kyphosis – a spinal disorder in which excessive curving of the spine results in an exaggerated forward rounding of the upper back.

Spinal compression fractures involving the anterior elements of the spinal column are considered stable fractures and most patients remain neurologically intact.

Once a diagnosis is confirmed, the first line of treatment is typically conservative pain management, usually involving some form of bracing or physiotherapy.

Some patients who fail conservative treatment may require hospitalization, long term care, and surgical interventions such as percutaneous vertebroplasty and balloon kyphoplasty.

How can bracing help osteoporosis patients?

Orthopedic back braces designed for the management of osteoporosis symptoms should perform some or all of the following functions:

• Control pain by limiting motion
• Stabilize injured structures by immobilizing the spine
• Provide pressure to promote correction and prevent deformity
• Reduce pain and fatigue
• Promote function or participation