What are the best treatments for reducing pain due to compression fractures?
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The answer remains unclear. Nasal salmon calcitonin is effective for analgesia of vertebral compression fractures (SOR A, based on a systematic review of randomized controlled trials [RCTs]). Although percutaneous vertebroplasty is slightly more effective than balloon kyphoplasty for reducing pain, it also has a higher refracture rate (SOR A, based on a meta-analysis). Isometric back-extensor muscle strengthening and proprioceptive postural retraining is more effective for prolonging time between refractures if there has not been a vertebroplasty (SOR B, based on a case series).
Evidence Based Practice 12(1): 04-05.