Is inversion table therapy beneficial for acute vertebral compression fractures?

From the Guidelines

Inversion table therapy is not recommended for acute vertebral compression fractures, as it may worsen the injury and is not a proven treatment method for this condition. The management of acute vertebral compression fractures typically involves medical management with pain control, limited bed rest, and gradual return to activity with appropriate bracing or support 1. In some cases, vertebroplasty or kyphoplasty procedures may be considered for patients who do not respond to conservative treatment 1. The use of inversion table therapy is not supported by the evidence and may potentially increase compression on the fractured vertebra or cause displacement of bone fragments, leading to increased pain or neurological complications.

Some key points to consider in the management of acute vertebral compression fractures include:

• Medical management with pain control using medications such as acetaminophen, NSAIDs, or prescription pain relievers
• Limited bed rest (1-3 days maximum) followed by gradual return to activity with appropriate bracing or support
• Physical therapy focusing on gentle strengthening exercises may be introduced once the acute phase has passed
• Vertebroplasty or kyphoplasty procedures may be considered for certain types of compression fractures that do not respond to conservative treatment 1
• Consultation with a spine specialist is recommended before attempting any therapy for spinal fractures

It is also important to note that the evidence does not support the use of inversion table therapy for acute vertebral compression fractures, and it is not recommended by the American College of Radiology or the American Academy of Orthopaedic Surgeons 1. Instead, patients should follow their physician's guidance and adhere to evidence-based treatment protocols to ensure the best possible outcomes.

From the Research

Inversion Table Therapy for Acute Vertebral Compression Fractures

• There is no direct evidence in the provided studies to support the use of inversion table therapy for acute vertebral compression fractures 2, 3, 4, 5, 6.
• The studies focus on various treatment options such as early rehabilitation 2, kyphoplasty and percutaneous vertebroplasty 3, analgesics and non-pharmacological treatment 4, and bracing, analgesics, and functional restoration 5.
• A systematic review with meta-analysis found insufficient evidence to inform conservative care for acute pain related to vertebral compression fractures, highlighting the need for large, multinational, placebo/sham-controlled trials 6.

Treatment Options for Vertebral Compression Fractures

• Early rehabilitation may be a feasible alternative for maintaining activities of daily living in patients with acute vertebral compression fracture 2.
• Kyphoplasty and percutaneous vertebroplasty are minimally invasive techniques to alleviate pain and correct the sagittal imbalance of the spine 3.
• Analgesics, particularly opioids, are commonly prescribed for vertebral compression fractures, but there is a lack of evidence to support this approach 4.
• Bracing, analgesics, and functional restoration are considered primary treatment options for acute osteoporotic vertebral compression fracture management 5.

Need for Further Research

• There is a need for clinical trials addressing the management of vertebral compression fractures to improve the quality of care patients receive 4.
• Large, multinational, placebo/sham-controlled trials are needed to address the gap in evidence for conservative care for acute pain related to vertebral compression fractures 6.