The origins of post-traumatic stress disorder (PTSD) for many people come from trauma. In recent studies, it seems that one of the main influencing factors of PTSD is linked to orthopaedic trauma and fractures specifically. Patients with PTSD also have a higher likelihood of fractures, creating a vicious cycle between PTSD and orthopaedic fracture that can debilitate your sleep, relationships, and overall quality of life.
Neuralia TMS offers transcranial magnetic stimulation (TMS). This non-invasive treatment helps target the parts of the brain that are connected with PTSD systems, which has been found to reduce the stress symptoms associated with PTSD. We’ll be investigating the association between PTSD and fracture trauma symptoms, studies, and treatment so you can understand your options moving forward.
Key Takeaways
- Orthopaedic trauma can impact your psychology, resulting in PTSD and depression.
- Symptoms of PTSD include re-experiencing, avoidance, arousal and reactivity, and cognitions and mood symptoms.
- PTSD fractures are orthopaedic fractures caused by the symptoms associated with PTSD.
- You are 12 to 24% more likely to receive an orthopaedic fracture if you have PTSD, according to contemporary studies.
- TMS can be an effective treatment for PTSD symptoms, especially when coupled with other types of treatment.
What is Post-Traumatic Stress Disorder?
PTSD is a disorder that affects the general health of people who have been involved in a traumatic event. While it’s very natural to feel fear during or after a dangerous event, PTSD is characterised by the continuation of symptoms over time. Most people who experience a range of symptoms after trauma will see their reaction diminish over time, but this isn’t the case for people with PTSD.
How is PTSD Linked to Orthopaedic Trauma and Fracture?
Post-traumatic stress disorder symptoms can increase the risk of fractures in a patient. The incidence of PTSD in fracture patients has been mostly limited to older adults. However, there is a statistically significant association according to a systematic review and meta-analysis of PTSD symptoms and fracture risk in older adults in the Fukushima Prefecture, Japan.
How does Orthopaedic Trauma Impact Your Psychology?
Orthopaedic trauma affects your psychology by causing you physical pain, disrupting your life, and limiting your mobility. Orthopaedic injuries are categorised as physical trauma to your bones, ligaments, joints, and muscles, which heavily contribute to the everyday activities we take for granted. When these injuries interfere with your daily life, it can have a major impact on your psychology, including:
- Frustration and irritability from chronic pain
- Loss of independence and emotional distress from a lack of mobility
- Boredom and financial panic from a disruption to your routine
- Depression from social isolation and chronic pain
- PTSD if a traumatic experience caused the injury
Does Orthopaedic Trauma Lead to PTSD? Studies and Statistics
Orthopaedic trauma and fracture have been directly linked to PTSD, especially if the type of fracture occurred during a violent and traumatic experience. A Journal of Trauma and Injury 2024 study found that orthopaedic trauma patients were highly likely to have signs of PTSD after the event when screened with the Injured Trauma Survivor Screen (ITSS).
Around 40% of orthopaedic trauma patients showed signs of PTSD when screened on average 7.1 days after the event that caused the injury. The most common types of injuries that caused PTSD were gunshot wounds (80%), falls from great heights (30%), and serious motor vehicle collisions (17%).
Common PTSD Symptoms in the Aftermath of Trauma
While PTSD can be difficult to link directly to the physical trauma of orthopaedic patients, several common PTSD symptoms (taken from the National Institute of Mental Health) can be identified, including:
Re-Experiencing Symptoms
- Experiencing flashbacks
- Having recurring memories or dreams related to the event
- Having distressing thoughts
- Experiencing physical signs of stress
Avoidance Symptoms
- Avoidance of places, events, and/or objects that are linked to the traumatic experience
- Staying away from thoughts and/or feelings related to the traumatic experience
Arousal and Reactivity Symptoms
- Easily startled or surprised
- Feeling tense or on edge
- Difficulty concentrating
- Difficulty falling asleep or remaining asleep
- General irritableness and/or angry outbursts
- Reckless and destructive behaviour
Cognition and Mood Symptoms
- Difficulty recalling key details of the traumatic experience
- Negative self-perception
- Exaggerated feelings of blame directed towards oneself or others
- Persistent negative emotions of fear, anger, guilt, and/or shame
- Trouble feeling positive emotions
- Disinterest in previous passions or activities
- Feelings of social isolation
While it may be common for everyone to feel these symptoms at one point or another, to be diagnosed with PTSD you must experience the following for at least 1 month:
- At least one re-experiencing symptom
- At least one avoidance symptom
- At least two arousal and reactivity symptoms
- At least two cognition and mood symptoms
What Responsibilities do Healthcare Workers have in Recognising PTSD?
It’s the responsibility of healthcare workers to not only address the psychological and physical impact of orthopaedic injuries, but also recognise symptoms as soon as possible. Since PTSD has a major effect on the health status of patients, healthcare workers must assess and analyse for symptoms of PTSD when dealing with fracture patients after traumatic events.
The key step to aiding orthopaedic injury patients who are showing signs of PTSD is to take a multidisciplinary approach that includes trauma counselling, and rehabilitation in the following forms:
- Teaching patients about expected emotional responses to orthopaedic injuries
- Creating strategies to manage pain and anxiety as they recover
- Allowing support from friends and family to help promote psychological well-being
- Approaching patients with an encouraging and understanding attitude
How does PTSD Affect Fractures?
There are several ways that PTSD can contribute to fractures, including:
- PTSD affects our calcium, which is a major component of our bone mineral density and strength.
- Patients with PTSD will often smoke or drink to cope with their symptoms, which leads to accidents and weakens bones.
- Older patients with PTSD are more susceptible to PTSD fractures, particularly spinal injuries.
How Common are PTSD Fractures?
A study of incident fractures in the Danish population in 2018 found that the risk of fractures occurring for people with PTSD was 24%, a statistically significant result for the average population. They concluded that there was an increased fracture risk in people with PTSD, stressing the importance of managing the prevalence of PTSD symptoms.
Similarly, another study in 2021 by BMC Geriatrics followed the correlations between bone fractures and PTSD in patients who experienced the Great East Japan Earthquake. After following older adults with PTSD from this dangerous event (a mean age of 56 years), they found that 12% of adults had fractures that were linked to symptoms associated with PTSD. They concluded that disaster-induced PTSD symptoms and insomnia led to increased fracture risk among older adults.
How to Mitigate PTSD Fractures Using Treatment and Therapy
The best way to reduce the likelihood of fracture sites is to mitigate the incidence of PTSD among patients using treatment and therapy. Alleviating the symptoms of PTSD and improving patient conditions following trauma will reduce fracture risk.
Luckily, the presence of PTSD has been studied for several years and there are currently several treatments that can help you with your diagnosis of PTSD and reduce symptoms, including:
- Cognitive Processing Therapy
- Prolonged Exposure Therapy
- Eye Movement Desensitisation and Reprocessing
- Stress Inoculation Training
- Medications
What are Emerging Therapies to Treat PTSD?
One of the most promising emerging therapies for treating PTSD is TMS. TMS is a non-invasive form of brain stimulation that has been shown to treat the symptoms of depression and PTSD. TMS uses magnetic fields to target specific areas of the brain that create and regulate the symptoms that may arise from severe trauma.
The areas are stimulated, which increases brain activity, encourages new neural connections, and with repeated treatments can stimulate the brain’s neuroplasticity. TMS in Australia has witnessed a surge in popularity, with clinics available in Perth, Melbourne, and Sydney. While the technology surrounding TMS isn’t new, access to Medicare and general affordability means that this type of therapy is now available to more people.
Individuals with PTSD can greatly benefit from TMS, especially if they are searching for a non-invasive treatment for PTSD.
Can I use Multidisciplinary Treatments at the Same Time?
Yes, you can. In fact, you’ll find that often using at least two different types of treatment to manage your PTSD symptoms will reduce stress and fracture risk more effectively than just one.
TMS therapy for PTSD is promising, and there is ongoing research that suggests that TMS has a potential efficacy for treating patients displaying symptoms of PTSD. The best type or combination of treatments for PTSD, as with any psychological trauma, is specific to the patient and employs a multidisciplinary approach to treatment.
Encouraging Proactive Mental Healthcare in Orthopaedic Trauma
Mental healthcare regularly suffers when dealing with a diagnosis and symptoms of PTSD, as well as the resulting increased risk of fractures. While approaches to combat the symptoms that arise from PTSD like depression are effective, they have side effects. Antidepressants, for example, can affect your sexual function and leave you feeling like a zombie.
Faced with these decisions, you can feel overwhelmed while coping with traumatic fractures and symptoms – luckily, there’s good news. Neuralia TMS offers non-invasive treatment that is Medicare & DVA covered for patients suffering from PTSD. Book an initial consultation or phone 6230 3996 to see how Neuralia TMS can help you.
FAQs on PTSD Orthopaedic Trauma and Fractures
Does TMS Treat PTSD?
Yes, TMS can be an effective treatment for PTSD. TMS treatments can be effective at treating a stress psychiatric disorder like PTSD, as well as OCD, Parkinson’s, chronic pain, and tinnitus.
Is TMS Therapy Painful?
No, TMS therapy is not painful. Some patients feel slight scalp discomfort, headache, scalp tingling, or lightheadedness. But generally speaking, these side effects are low to moderate and go away quickly after a session. On the other hand, many patients have commented on how relaxing the experience can be.
We understand that numerous PTSD patients will feel on edge or uncomfortable in sensitive situations, which makes TMS a desirable treatment. Lots of our patients will listen to music, watch shows on Netflix, or chat with our friendly TMS nurses throughout their treatment.
Can TMS be used with Other PTSD Treatments?
Yes, TMS is an excellent complement to other therapeutic approaches to PTSD. Improvement in the psychological stress caused by PTSD among patients is best treated with a comprehensive treatment plan that can involve multiple types of treatments.
Back to Top: Understanding PTSD in the Context of Orthopaedic Trauma and Fractures
