Persistent Discomfort After Vertebroplasty: Causes and Solutions

Persistent soreness after bone cement surgery?

Hello, Doctor! I would like to ask about my mother, who recently had an accident.
She was diagnosed with osteoporosis at -2.5% and underwent vertebroplasty and hip surgery.
Initially, she experienced severe pain, panic, and depression, but her condition has gradually improved.
According to what I read online, about 90% of her pain has alleviated, but she still experiences persistent "soreness" in her lower back, which is not painful.
All the doctors she has seen have advised her to exercise, as she is quite underweight.

I have researched that soreness can occur after vertebroplasty, but I didn't expect her to feel sore after standing for a short time, which prevents her from exercising more.
After any physical activity, she feels the need to lie down immediately for relief.
Follow-up X-rays have shown no issues.
I would like to ask the doctor the following questions:
1.
Is this soreness due to a lack of exercise and the accumulation of lactic acid from physical activity?
2.
If this soreness is related to the vertebroplasty, how long can we expect it to last? Will it improve after a certain period?
3.
Are there any simple exercises or medications that can help alleviate this soreness and help her get through this period?
Thank you for your response, Doctor.
It’s difficult to see my mother constantly complaining about the soreness, and she even asks me to take her for rehabilitation, which leaves me feeling helpless.
I only know that soreness is a common symptom after vertebroplasty, but I didn't expect it to trouble her so much.
Thank you again!

Dora Wang, 40~49 year old female. Ask Date: 2023/10/14

Dr. Chen Bochen reply Orthopedics

Hello, bone cement itself does not cause acidity, but there are many injured joints, muscles, and ligaments that cannot be treated with bone cement.
These injuries generally require a combination of rehabilitation, brisk walking exercises, and hot compress therapy, along with the use of a lumbar support to expedite recovery.

Reply Date: 2023/10/14

More Info

Persistent discomfort after vertebroplasty, particularly the sensation of "soreness" or "ache" in the lumbar region, can be a common experience for patients following this procedure. Vertebroplasty is a minimally invasive procedure used to treat vertebral compression fractures, often due to osteoporosis. While many patients experience significant relief from acute pain, some may continue to feel discomfort in the surrounding areas. Here, I will address your questions and provide insights into the potential causes and solutions for your mother's ongoing discomfort.

1. Is the soreness due to lack of exercise and lactic acid buildup?
Yes, it is possible that the soreness your mother is experiencing is related to a lack of physical activity. When individuals are inactive for an extended period, their muscles can weaken, and any subsequent activity can lead to muscle fatigue and soreness. This is often due to the accumulation of lactic acid, which occurs when muscles are exerted beyond their usual capacity. However, it is essential to differentiate between soreness from muscle fatigue and pain that could indicate complications from the vertebroplasty. Since your mother has been advised to exercise, it is crucial to start with gentle activities that can help strengthen her muscles without overexerting them.

2. If the soreness is related to the bone cement, how long will it last?
The sensation of soreness following vertebroplasty can be multifactorial. While the bone cement itself typically does not cause discomfort, the surrounding soft tissues may react to the procedure. This discomfort can be temporary and may improve as the body adjusts to the changes. Generally, the soreness should gradually decrease over weeks to months as healing progresses. However, if the discomfort persists or worsens, it is essential to consult with a healthcare provider to rule out any complications, such as cement leakage or adjacent segment disease.

3. What simple exercises or medications can alleviate the soreness?
To help manage the soreness, consider the following approaches:
- Gentle Stretching and Strengthening Exercises: Encourage your mother to engage in low-impact activities such as walking, swimming, or gentle yoga. These exercises can help improve flexibility and strengthen the muscles supporting the spine. It is advisable to consult a physical therapist who can design a tailored exercise program that considers her current condition and limitations.

- Heat Therapy: Applying heat to the affected area can help relax muscles and alleviate soreness. A warm compress or heating pad can be beneficial.

- Over-the-Counter Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen can help manage discomfort. However, it is essential to consult with her physician before starting any medication to ensure it is safe and appropriate for her situation.

- Physical Therapy: If the soreness persists, a referral to a physical therapist may be beneficial. They can provide targeted exercises, manual therapy, and modalities to help reduce discomfort and improve function.

In conclusion, while it is common for patients to experience some level of discomfort after vertebroplasty, it is essential to monitor the symptoms closely. Encourage your mother to engage in gentle physical activity, utilize heat therapy, and consider over-the-counter pain relief as needed. If her symptoms do not improve or if she experiences any new or worsening symptoms, it is crucial to follow up with her healthcare provider for further evaluation and management. The goal is to help her regain strength and mobility while ensuring her comfort during the recovery process.

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