Vertebral Fractures

A 72-year-old woman presents with a 2-month history of increasing pain in her lower back, which has not improved with ibuprofen and is causing difficulty with walking and dressing. On questioning, she reports having lost about 5 cm (2 in.) of height since she was a young woman. On examination, there is mild kyphosis in her lower thoracic spine but no point tenderness. A lateral spine radiograph reveals that the L2 vertebra is biconcave in appearance, a finding that is consistent with a vertebral fracture (Fig. 1). How should this case be managed?