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Neuro Doctor
Neuro Doctor, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5087
Experience:  American Board Certified Neurologist, Internal Medicine
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I am 88 yr old WM trippe and landed on 5 days ago. Severe

Customer Question

I am 88 yr old WM trippe and landed on butt 5 days ago. Severe low back pain. Xray showed 50% compression L4 osteoporosis. Had first PT 2 days ago Symptoms worse. Taking Alleve and Tylenol bid. ? prognosis
Submitted: 1 year ago.
Category: Neurology
Expert:  Neuro Doctor replied 1 year ago.
Hi, I am an American Board Certified Neurologist and I am very glad to help you with your health concerns.
To your main question on the prognosis, please see that the prognosis for vertebral compression fracture is excellent, the pain takes some time to come under control but eventually most patients recover well and also without any complications.
Along with worsening of the pain if you are also developing new neurological symptoms like bladder or bowel disturbances or weakness of the legs or numbness or loss of sensation of the legs etc then this is an emergency and you need to visit the ER asap so that they can investigate you further to rule out any damage to nervous system structures like spinal nerve roots etc. If the above mentioned neurological symptoms are absent then it does not look like you are developing any damage to the spinal nerves so our focus will be on controlling the pain.
For controlling the pain you need to take stronger pain pills. Aleve and Tylenol are not strong enough. You may try stronger pain pills like Lortab or Percocet etc. Lidoderm anesthetic skin patches is another option. Electrotherapies like TENS (Transcutaneous Electric Nerve Stimulation) or Interferential therapy too can be of immense help. Diathermy is another option to get relief from this type of severe pain. You may stop the physical therapy for some time until the pain starts getting better then slowly restart the physical therapy. If you are not using a lumbar belt (lumbar brace) please start using it to limitize the spinal movements which will give rest to the fractured vertebra and help in faster healing process. The osteoporosis needs appropriate treatments too. If the pain persists despite all these above measures then there are more specialized treatments like Kyphoplasty or Vertebroplasty etc which should help in relieving this severe pain.
Once again I reassure you the prognosis should be excellent, in the meantime please make sure you are not having the neurological symptoms mentioned earlier above, if you are having any of those symptoms then please get investigated asap to rule out developing any neurological complications, if those symptoms are absent then the main focus should be on controlling this severe pain and I hope you find the above recommendations helpful in bringing this severe pain under control.
All the very best!
Please let me know if you have any further questions; and if you feel you have received the answer to your question please rate me so that I can receive credit for the time and effort put by me in answering your question.
Best regards,
Neuro Doctor