Recovery from Burst Fractures: Key Questions Answered - Orthopedics

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Vertebral fracture


Hello, Dr.
Chen! I was rear-ended on the highway and ended up with a "burst fracture of the third vertebra," with a 0.3 cm vertebral body depression, but no nerve compression.
Although surgery is not required at this time, the doctor advised me to rest at home for three months, wear a brace while moving, and continue monitoring for bone healing.
Since my follow-up appointment is next week, I have some concerns I would like to ask about:
It has been three weeks since the incident.
I only wear the brace when I go outside for sunlight, eat, use the bathroom, or shower; otherwise, I remain in bed.
However, over the past few days, I have experienced occasional soreness and pain on both sides of the injury site while sitting with the brace on.

1.
Given my situation, when can I start doing some stretching exercises? For example, can I stretch my arms upward while standing or lift my legs while lying in bed? What joint exercises can I perform?
2.
Since I have been mostly bedridden for the past three weeks, is this the correct approach? Should I start wearing the brace more often and try to walk or sit more?
3.
Generally speaking, will I need rehabilitation after this condition? How can I determine if rehabilitation is necessary? If needed, how long after the injury should I wait before starting rehabilitation?
Thank you very much!

TingTing, 30~39 year old female. Ask Date: 2023/08/16

Dr. Chen Bochen reply Orthopedics


Hello, 1.
To determine the condition, it is generally recommended to follow up with X-rays every 6 weeks.
2.
It is correct to rest for the first three weeks; thereafter, when getting out of bed, you should wear a supportive brace and avoid bending at the waist.
3.
After the fracture has healed (approximately 2-3 months), it is advisable to gradually start resuming physical activity.
Engaging in rehabilitation can help you recover more quickly.

Reply Date: 2023/08/16

More Info


Hello! It sounds like you’ve been through a very challenging experience with your burst fracture, and I commend you for seeking information about your recovery. Let’s address your questions one by one, while also providing some general insights into recovery from such injuries.

1. When can you start stretching and joint exercises?
After a burst fracture, especially one that does not involve nerve compression, it’s crucial to follow your physician’s advice regarding movement. Generally, light stretching and gentle movements can begin once you feel comfortable and your doctor gives the green light. Typically, this might be around 4 to 6 weeks post-injury, but it varies based on individual healing rates. Simple movements like raising your arms while lying down or gentle leg lifts can help maintain mobility without putting too much strain on your spine. Always listen to your body; if something causes pain, stop immediately.

2. Is it correct to spend most of your time lying down?
While resting is essential for healing, prolonged bed rest can lead to stiffness and muscle atrophy. It’s important to balance rest with gentle movement. Wearing your back brace when sitting or standing is advisable, as it provides support to your spine. Gradually increasing your activity level, such as sitting up for longer periods or taking short walks around your home, can be beneficial. However, ensure that any movement is done carefully and with the brace on to prevent any risk of further injury.

3. Will you need rehabilitation?
Rehabilitation is often a critical component of recovery from spinal injuries. The need for rehab typically depends on your symptoms, mobility, and overall recovery progress. If you find that you have persistent pain, stiffness, or difficulty with movement as you heal, it may be beneficial to consult a physical therapist. They can provide tailored exercises to strengthen your back and improve flexibility. Generally, rehab might start around 6 to 12 weeks post-injury, depending on your healing progress and your doctor’s recommendations.

In addition to your specific questions, here are some general tips for recovery from a burst fracture:
- Nutrition: Ensure you are consuming a balanced diet rich in calcium and vitamin D to support bone healing. Foods like dairy products, leafy greens, and fortified foods can be beneficial.


- Hydration: Staying well-hydrated is essential for overall health and can aid in recovery.

- Pain Management: If you experience pain, discuss with your doctor about appropriate pain management strategies. Avoid any medications that could interfere with your recovery unless prescribed.

- Follow-Up Care: Regular follow-ups with your healthcare provider are crucial to monitor your healing process. They may perform imaging tests to assess the status of your fracture and adjust your treatment plan accordingly.

- Mental Health: Don’t underestimate the emotional toll of recovery. It’s normal to feel frustrated or anxious. Consider talking to a mental health professional if you find it hard to cope.

Remember, every individual heals at their own pace, and it’s essential to be patient with yourself during this process. Always consult your healthcare provider before making any changes to your activity level or treatment plan. Wishing you a smooth and speedy recovery!

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