[{"@context":"https:\/\/schema.org\/","@type":"Article","@id":"https:\/\/betterbones.com\/fractures-and-healing\/new-york-times-spinal-fracture-article\/#Article","mainEntityOfPage":"https:\/\/betterbones.com\/fractures-and-healing\/new-york-times-spinal-fracture-article\/","headline":"The New York Times got it wrong on spinal fractures","name":"The New York Times got it wrong on spinal fractures","description":"Print PDF eBook Facebook Twitter Gmail LinkedIn Pinterest Today, I read with dismay The New York Times\u2019 health column about vertebral compression fractures. In my opinion, it presented an inaccurate picture of what\u2019s happening when it comes to spinal fractures. I want to address some of the points that stood out for me because I […]","datePublished":"2011-06-30","dateModified":"2026-04-22","author":{"@type":"Person","@id":"https:\/\/betterbones.com\/author\/brownbetterbonesgmail-com\/#Person","name":"Dr. Susan E. Brown, PhD","url":"https:\/\/betterbones.com\/author\/brownbetterbonesgmail-com\/","identifier":72,"image":{"@type":"ImageObject","@id":"https:\/\/secure.gravatar.com\/avatar\/8e08d87bd45250c6616e1752933a6576aba077f335d97ee337a0cde5e435cbd3?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/8e08d87bd45250c6616e1752933a6576aba077f335d97ee337a0cde5e435cbd3?s=96&d=mm&r=g","height":96,"width":96}},"publisher":{"@type":"Organization","name":"Center for Better Bones","logo":{"@type":"ImageObject","@id":"https:\/\/betterbones.com\/wp-content\/uploads\/2018\/12\/Better-Bones-AMP.png","url":"https:\/\/betterbones.com\/wp-content\/uploads\/2018\/12\/Better-Bones-AMP.png","width":150,"height":60}},"image":{"@type":"ImageObject","@id":"https:\/\/betterbones.com\/wp-content\/uploads\/2019\/01\/osteoporosis-blog.jpg","url":"https:\/\/betterbones.com\/wp-content\/uploads\/2019\/01\/osteoporosis-blog.jpg","height":512,"width":1024},"url":"https:\/\/betterbones.com\/fractures-and-healing\/new-york-times-spinal-fracture-article\/","about":["Fractures & Healing"],"wordCount":1001,"keywords":["spinal fracture"],"articleBody":" Print PDF eBook\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tFacebook\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tTwitter\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tGmail\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tLinkedIn\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tPinterest\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tToday, I read with dismay The New York Times\u2019 health column about vertebral compression fractures. In my opinion, it presented an inaccurate picture of what\u2019s happening when it comes to spinal fractures. I want to address some of the points that stood out for me because I feel this article spreads a lot of fear where it\u2019s just not necessary \u2014 and as I mentioned in a recent post, fear itself is damaging to bone!First, let\u2019s look at the statement that \u201cby age 80, two in every five women [or 40%] have had one or more vertebral compression fractures.\u201d Similar statistics have been bandied about for years, but when I took the time to look for hard data supporting them a few years ago, I found it very difficult to substantiate such high numbers. The sole large-scale study that looked at long-term risk of vertebral fractures, a review by J.A. Cauley and colleagues that came out in 2007, actually debunks this statement. As I noted in my article on spinal fractures at the time, “The results of this study suggest that earlier estimates of spinal vertebral fracture incidence have overestimated real fracture incidence. Over fifteen years, from age 68 to 84, only 18% of all US Caucasian women experienced a vertebral fracture. Overall, counting those who entered the study with an existing vertebral fracture, a little over 26% of all women had radiological evidence of a spinal fracture by age 84. This figure is significant, yet not as worrisome as the 35\u201050% estimate previously reported.”I also take issue with the statement that \u201cvertebral fractures are a telltale sign of bone loss.\u201d They\u2019re not \u2014 they\u2019re a sign of bone weakness, and there is a difference between the two! While low bone density does increase the risk of fracture, most fractures occur in persons whose bone mineral density is above the osteoporotic range. The strongest predictors of fracture in the Cauley study were advancing age, having low body weight, and the presence of a prior bone fracture \u2014 not low bone mineral density.Now, I have been arguing for years that bone mineral density alone doesn\u2019t predict fracture risk, and the study on which this article is based seems to agree with that assessment on its surface. The study\u2019s authors note that the presence of vertebral fractures in women whose bone density isn\u2019t osteoporotic means that the true diagnosis should be osteoporosis, not osteopenia \u2014 and with that, I\u2019d agree. But the follow up statement shows where all this is truly headed: \u201cAsked if such women should receive bone-preserving medication, Dr. Ensrud said emphatically, \u2018Yes!\u2019\u201d This position is in direct contrast to the recommendations of the U.S. Surgeon General \u2014 that persons with bone loss should be directed to make changes to their dietary and exercise habits first, then assessed and treated for the cause of the bone loss, and then put on bone medications if the situation warrants. (The implicit assumption of Dr. Ensrud\u2019s response is that bone drugs are always warranted.)The idea of looking for the causes behind skeletal weakness is not even suggested, and the word \u201cexercise\u201d doesn\u2019t appear in the New York Times\u2019 article until the very last line. Yet numerous studies show low vitamin D levels to be a major cause of bone loss and weakening among most of those who fracture. Exercise, as countless more studies have shown, should be the first line of defense against osteoporosis and fractures \u2014 and considering that a Mayo Clinic study has shown a 300% reduction in risk of new vertebral fractures from simple back strengthening exercises (far more than ANY bone drug can claim), it is disturbing that Fosamax is mentioned so much more prominently than exercise.I could go on (and on), but rather than write a novella, I\u2019ll state my primary issue thus: The overall message is that multitudes of postmenopausal women are destined to fracture in their spine, and that they should immediately be given bone drugs for even a minor, unfelt, spinal deformity defined as a \u201cfracture\u201d. I would hope for a more balanced, public-interest analysis of this important health issue from one of the most important news outlets in the United States, if not the world.One other note before I stop \u2014 I also find it troubling that all of these messages are aimed primarily at women. Studies in the U.S., Canada, and several European countries show that older men often have \u201csilent\u201d vertebral fractures (only seen upon X-ray) just as frequently as women do, yet the article makes no mention of looking for these hidden fractures in men and giving them drugs for these symptom-less vertebral deformities.But here\u2019s the bottom line: women and men with osteoporosis, even those found to have a \u201csilent\u201d symptom-less vertebral deformity in old age, need not automatically be given bone medications. It has been the position of the U.S. government\u2019s top health official for most of the past decade that medication is the last resort, not the first! And that is a message that I hope all my readers get \u2014 and pass along. References:Brody, J.E. 2011. Along the spine, women buckle at breaking points. New York Times June 27, 2011.Cauley, J. A., Hochberg, M. C., Lui, L. Y., et al. 2007. Long\u2010term risk of incident vertebral fractures. JAMA 298(23):2761\u20102767.O’Neill T. W., Felsenberg D., Varlow J., et al. 1996. The prevalence of vertebral deformity in European men and women: the European Vertebral Osteoporosis Study. J. Bone Miner. Res. 11:1010.Brown, S. E. 2008. Spinal vertebral fractures among US Caucasian women: New statistics and new insights. URL: https:\/\/betterbones.com\/wp-content\/uploads\/2016\/11\/spinalvertebralfracture.pdf.Davies K. M., Stegman M. R., Heaney R. P., Recker R. R. 1996. Prevalence and severity of vertebral fracture: the Saunders County Bone Quality Study. Osteoporos. Int. 6:160. Nutritional support is key to recovery \u2014 see our guide to bone-healing nutrition essentials.To understand the underlying bone health picture, visit our natural osteoporosis support guide."},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Fractures And Healing","item":"https:\/\/betterbones.com\/fractures-and-healing\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"The New York Times got it wrong on spinal fractures","item":"https:\/\/betterbones.com\/fractures-and-healing\/new-york-times-spinal-fracture-article\/#breadcrumbitem"}]}]