PTSD and Fractures: What is the Link?
Medically reviewed by Nicole Washington, DO, MPH — Written by Zia Sherrell, MPH on September 26, 2024
Connection
Research
Other Physical Effects
PTSD Treatment
Seeking Help
Self-Care
Summary
There is evidence suggesting that post-traumatic stress disorder (PTSD) increases the risk of fractures. This correlation may be attributed to the effects of chronic stress on bone density and structure.
PTSD is a mental health condition that some individuals develop following a traumatic event. Symptoms can include flashbacks, nightmares, and anxiety. Without appropriate support, these symptoms may persist over an extended period. Additionally, elevated levels of stress hormones can adversely affect physical health over time, including bone health.
This article examines the relationship between PTSD and fractures, explores the underlying mechanisms, treatment approaches, and guidance on when to seek help.
Can PTSD Cause Fractures?
PTSD does not directly cause fractures; however, chronic stress can significantly impact bone health, potentially leading to an increased risk of fractures. Elevated stress hormones, such as cortisol, are prevalent in individuals with PTSD. These hormones can disrupt bone metabolism and decrease bone density over time. If a person develops osteoporosis, their bones become more susceptible to fractures.
Furthermore, individuals with PTSD may engage in behaviors detrimental to bone health, such as consuming a poor diet, smoking, substance abuse, or excessive alcohol consumption.
Research on PTSD and Fracture Risk
Several studies indicate that individuals with PTSD are more likely to experience fractures. A 2018 study involving over 4,000 Danish individuals with PTSD revealed that they were 1.7 times more likely to suffer fractures than the general population. This heightened risk was consistent across various ages, genders, and health conditions.
Another 2018 study compared over 6,000 individuals with PTSD to 24,000 without the condition and found that those with PTSD were significantly more likely to develop osteoporosis as they aged.
A more recent 2021 study involving 17,474 older adults who survived the Great East Japan Earthquake found that PTSD substantially increased the risk of fractures. The authors noted that insomnia and the use of sleeping pills also contributed to this risk.
Can PTSD Cause Other Physical Damage?
PTSD can lead to a range of physical health issues. Chronic stress associated with PTSD can weaken the immune system, making individuals more susceptible to infections, illnesses, and autoimmune conditions.
Research has also linked PTSD to an increased risk of cardiovascular diseases, including hypertension, heart disease, and stroke. The constant state of heightened arousal and stress can lead to elevated blood pressure and increased heart rate, placing undue strain on the cardiovascular system, potentially resulting in the development or exacerbation of heart-related conditions.
Additionally, individuals with PTSD are more likely to experience gastrointestinal issues, including irritable bowel syndrome (IBS).
Can PTSD Treatment Help?
While PTSD treatment may assist in preventing or reversing some of the physical effects of the condition, current research does not demonstrate that treatment specifically reduces the risk of fractures. However, addressing PTSD may lower stress hormone levels over time, which could benefit overall physical health. Treatments for PTSD include:
- Prolonged Exposure (PE): This therapy gradually exposes individuals to memories, feelings, and situations related to the trauma to help them confront and process these experiences.
- Cognitive Processing Therapy (CPT): CPT aids individuals in reframing negative thoughts and beliefs associated with their trauma.
- Eye Movement Desensitization and Reprocessing (EMDR): EMDR reduces the intensity of traumatic memories, facilitating their processing by the brain.
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): TF-CBT helps individuals identify and alter unhelpful thought patterns and behaviors.
There are no medications specifically designed for PTSD; however, some individuals find benefit from certain antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), which may alleviate symptoms like anxiety or depression. Notably, some evidence suggests that SSRIs might increase the risk of osteoporosis, so individuals interested in these treatments should discuss the potential benefits and risks with their healthcare provider.
When to Seek Help
Anyone experiencing persistent mental health symptoms—such as flashbacks, nightmares, anxiety, or low mood—should seek professional support whenever possible. Additionally, individuals noticing physical health changes, such as unexplained pain or frequent injuries, should consult a healthcare professional.
In cases where someone experiences thoughts of self-harm or suicide, immediate assistance is critical.
Suicide Prevention
If you know someone at immediate risk of self-harm, suicide, or harming another person:
- Ask the difficult question: “Are you considering suicide?”
- Listen to the individual without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to connect with a trained crisis counselor.
- Remain with the individual until professional help arrives.
- If safe, try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is experiencing suicidal thoughts, resources are available. The 988 Suicide and Crisis Lifeline is accessible 24 hours a day at 988. Individuals who are hard of hearing can use their preferred relay service or dial 711 followed by 988.
Self-Care for PTSD
In addition to professional treatments, self-care strategies can help individuals with PTSD mitigate the condition’s effects on their mental and physical health. Recommended practices include:
- Eating a Balanced Diet: Adequate protein, calcium, and vitamin D intake is vital for bone health. Many nutrients also support mental health and mood.
- Exercising: While not a cure-all, regular exercise can enhance mental health. Weight-bearing exercises may strengthen bones.
- Learning Relaxation Techniques: Practices such as yoga, meditation, and deep breathing exercises can help reduce stress levels. Grounding techniques may assist in coping with PTSD symptoms when they arise.
- Getting Sufficient Sleep: Prioritizing consistent, quality sleep is essential. Establishing a calming bedtime routine may be beneficial.
- Reducing Harmful Behaviors: Individuals should consider reducing or eliminating unhealthy coping mechanisms, such as smoking or excessive drinking. Though these behaviors may provide temporary relief, they can worsen mental and bone health over time.
- Regular Check-Ups: Attending screenings for conditions like osteoporosis, particularly as one ages, can aid in early identification and treatment.
Summary
Research indicates that individuals with post-traumatic stress disorder (PTSD) face an increased risk of fractures, potentially due to chronic stress’s impact on bone health. Certain behaviors, such as smoking or drinking, may further exacerbate this risk.
PTSD is a multifaceted condition with both mental and physical repercussions. Caring for both body and mind can help mitigate these effects, though research is ongoing. Individuals concerned about the impact of PTSD on their physical health should consult with a doctor or mental health professional experienced in trauma.
Through a combination of effective treatments, lifestyle adjustments, and self-care strategies, individuals may find resolution for PTSD.
