Managing osteoporotic fractures minimizing pain and disability.

The first step in pain management of vertebral compression is recognizing that a fracture has occurred. Acute pain, chronic pain, and deformity can decrease quality of life. Pain can be managed with narcotic analgesics, nonsteroidal anti-inflammatory drugs, mild muscle relaxants, calcitonin, occasional brief bed rest, bracing, and physical therapy modalities. Early mobility helps minimize continued bone loss and promotes muscle mass. An exercise program in these osteopenic/osteoporotic patients can be tailored by determining the bone mineral density of the patient. Those with thinner bones must start with low impact exercises with minimal fall risk.