You’re At Double the Risk of Spinal Fractures If You Have This Common Skin Condition

Find out what common skin condition can increase your risk of spinal compression fractures, and what you can do about it.

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Do you frequently have bouts of red, itchy skin? You should probably get that checked out. You may have eczema, and if you do you may also have bigger problems than discomfort. A large-scale study using data from more than 3 million people suggests that eczema raises the risk of spinal fractures (as well as hip and pelvic fractures). The worse the eczema, the bigger the risk.


Eczema can raise the risk of compression fracturesEczema can raise the risk of compression fractures

The study, published in the February 2020 issue of The Journal of Allergy and Clinical Immunology (JACI),looked at medical records, including hospital admissions, for nearly 3.1 million adults in the U.K. There’s some evidence that eczema itself causes bone loss, and some of its treatments—specifically, systemic corticosteroids (in pill form, as opposed to a cream or ointment rubbed on the eczema patches)—definitely do. This latest study is the best quality evidence yet that you really need to take care of your spine if you have eczema.

How Do I Know If I Have Eczema?

There are a few types of eczema, but the kind in this study is atopic eczema, also called atopic dermatitis. “Atopic” just means that whatever reaction—in this case, it’s scaly, itchy skin and other symptoms (see below)—isn’t caused by contact to something you’re allergic to.

Atopic eczema is the most common form of eczema. Symptoms include:

  • Dry, scaly skin
  • Red, inflamed patches
  • Severe itchiness
  • Skin that’s cracked or oozing

Eczema can raise the risk of compression fracturesEczema is a common condition that causes itchy, red, sometimes scaly skin.

Eczema usually starts in infancy and can last your whole life. A dermatologist or allergist can usually diagnose atopic dermatitis just by looking at it. Your doctor may want to rule out other causes of scaly, itchy skin by applying small amounts of various substances to your skin to see if you have an allergic reaction.

Eczema and Fracture Risk

Although other research suggests that eczema is linked to osteoporosis—loss of bone mass—and fracture risk, the JACI study wanted to look at whether the risk of fracture increased with eczema severity, as well as consider any other factors such as body mass index, steroid use and age.

As to the first question—does the risk of fracture go up when atopic dermatitis is more severe?—the answer is yes, according to the study. Overally, people with atopic eczema had a nearly 20% increased risk for spinal fractures. But for those who had the most serious cases of eczema, spine fracture risk was more than doubled.

What Are Compression Fractures?

When the researchers write about “spinal fractures” they’re talking about vertebral compression fractures, also known as osteoporotic compression fractures. Simply, it’s when your vertebrae crack, usually because your bones aren’t strong enough to support your weight and fight gravity.

Compression fractures are most often the result of osteoporosis, which is when your body loses bone tissue faster than it can replace it. Osteoporosis is especially common in postmenopausal women, who lose the bone-protective effects of estrogen after menopause. It’s called osteoporosis because the bones become porous—full of holes.

Spine osteoporosisBones with osteoporosis look like a sponge.

Compression fractures literally compress your vertebrae and cause them to lose their height and proper shape. This does a few things. The loss of height can cause the damaged vertebra to press on the nerve roots below it. That’s called nerve compression or nerve impingement. Ever heard of a pinched nerve? That too. Whatever it’s called, it can cause back pain or pain radiating down the arms or legs.

Also, if enough vertebrae get damaged, it can cause a change to your spinal curvature called kyphosis. A little kyphosis in the thoracic spine is natural, but too much can change your posture, forcing you to take on a stooped or hunchback look. This can cause your muscles to get tired and sore more easily, interfere with movement and, in the most severe cases, even disrupt your breathing.

Treating Osteoporosis and Compression Fractures

Luckily, you have options for treating both osteoporosis and compression fractures. First, it’s important to promote good bone health. Bones need calcium and vitamin D to regenerate. People with osteoporosis usually have deficiencies in one or both. You can get calcium from dairy products and green leafy vegetables, while the best source of vitamin D is getting plenty of sunlight. In a pinch you can take calcium or vitamin D supplements, but it’s more effective to get them both naturally.  

Resistance training also promotes bone health, especially anything load-bearing. You don’t need to be lifting Arnold Schwarzenegger-levels of weights, either. Know your limits and use whatever equipment’s available: barbells, dumbbells, and kettlebells are all good gear to use. Back squats (with the barbell behind your neck and across your shoulders) and any standing exercises are particularly good because they stress your spine, causing the vertebrae to produce more bone tissue.

If you have one or more compression fractures, your first treatments will likely be pain control, bracing and observation. Many compression fractures will heal on their own in two to three months. However, if pain persists or the fracture gets worse, a kyphoplasty or vertebroplasty may be helpful.

Kyphoplasty and vertebroplasty are minimally invasive procedures where the surgeon uses small incisions, small tools and a flexible camera attached to a video monitor to see your vertebrae, which eliminates the need to make a big incision to access your spine.

Compression fracture X-rayCompression fractures can cause pain, an abnormal curve and loss of height for vertebrae that are affected.

During kyphoplasty, your surgeon will deliver a balloon through a needle directly into your fractured vertebra, then blow it up to restore the backbone’s height. It’ll be further reinforced with bone cement. A vertebroplasty is a similar procedure, but it doesn’t use the balloon, just cement.

Most people find vertebroplasty and kyphoplasty recovery to be quick and easy since they’re minimally invasive procedures. They’re almost always outpatient procedures (no hospital stay necessary), and you’ll be able and encouraged to return to your daily activities as soon as possible. Best of all, many people experience pain relief almost immediately after a kyphoplasty or vertebroplasty.

Are you at risk for osteoporosis or compression fractures? Then see our ultimate patient guide to compression fractures and kyphoplasty. Get answers to all your questions. Still having trouble? Find a spine surgeon near you who can help.


Updated on: 03/16/20
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Howard S. An, MD
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