Vertebral fractures with no known cause

[jn2814]

In January 2019 my mum in law started getting pain in her back (thoracic area on the right side) with no history of trauma.
She attended a physio who provided exercises and carried out manipulations (exact details unknown). After these she felt her pain moved more centrally but thought no more about it at the time.
The physio then suggested she may have Osteoporosis. A dexa scan followed and showed 3 compression fractures but all other investigations were well within normal limits, including for Osteopenia and bone cancer.
She’d had a CT scan in December 2018 for another reason and when this was rechecked there were no spinal fractures present.
She has also been investigated by Haematology but again all results were normal.
So she has 3 vertebral compression fractures with no apparent reason for them and at present no plans for further investigations.
I’m a physio to trade but haven’t done MSK for years. My questions therefore are:
- does anyone have any experience of a similar situation?
- without a history of osteoporosis, is it at all feasible that manipulations could have caused this?
Many thanks in advance

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[toronto_physio]

I think you posted in another section so I've copied my same reply here:

I assume these fractures were in the thoracic spine? I'd say given the proximity of the CT and the manipulations, there's a good chance of the maneuver causing the fractures.

It would help to know which manipulation was done. For example, a prone technique would make it more likely.

Did your mom notice any unusual pain with twisting or bending after the treatment?

[jn2814]

Thanks for your reply. Fractures are in thoracic spine, technique I think was prone but no further details. She noticed that her pain had moved more centrally, rather than on the right side post intervention but I’m unclear regarding specifically rotating or bending. Sorry not to be more specific.

[toronto_physio]

Thanks for your reply. Fractures are in thoracic spine, technique I think was prone but no further details. She noticed that her pain had moved more centrally, rather than on the right side post intervention but I’m unclear regarding specifically rotating or bending. Sorry not to be more specific.

Based on this information, I think it's likely the manipulation caused the fractures, but without a history of bone issues, it's hard to blame the PT for them. Fractures are a known risk for manipulations.

Unless you are planning to file a lawsuit, I'd say go to another clinic, get the fractures healed, and move on from this incident. Speedy recovery to your mom!

[jn2814]

We’re absolutely not about apportioning blame nor filing lawsuits, just intrigued as to what could have caused these. And with a mum in law who likes to use google and convince herself there is something more sinister going on!
Had it not been for her saying the pain changed post manipulation, I wouldn’t even have considered asking.
Thanks very much again for your response.