What is a compression fracture?

A compression fracture is tiny cracks or breaks in the vertebrae-your vertebrae-the bones that make up your spinal column. They occur in the vertebral body, a thick, rounded part in front of each vertebra. The fractures in the bone lead to your weakening and collapsing spine. These fractures can even change your posture eventually.

Compression fractures may occur throughout your spine, but they occur most frequently in the middle region, which is known as the thoracic area. Osteoporosis, the weakening of the bone, is the most frequent cause of compression fractures, besides trauma, such as after an automobile accident or tumor.

Depending on the cause and severity of the bone break, a doctor will treat these fractures with medications, a back brace, or surgery.

You might find your provider uses terms when discussing a compression fracture, including:

• Spinal compression fracture.
• Vertebral compression fracture.

What are the symptoms of a compression fracture?

Symptoms of a compression fracture can include:

• Sudden onset back pain that initially improves with rest but worsens when trying to move
• The trouble with mobility and flexibility (you may need help standing, walking, bending, or twisting).
• Numbness, tingling in your back (compression or pinching of nerves).
• You may find tenderness over the site of the break
• Muscle weakness or spasms.
• The symptoms of a compression fracture may range from mild to severe. For some slight fractures, you may not observe or experience anything at all.
• A standard indicator of compression fracture is the loss of height. The damage in the bone can cause a collapse that may affect your height.

What is the cause of a compression fracture?

Pressure on or against the vertebrae of your spine can cause your spinal bones to break and collapse. Some of the most common causes of a compression fracture include:

• Osteoporosis: Your bones gradually grow weaker with age. Weaker bones are more likely to fracture. Severe osteoporosis fractures can occur while doing daily activities like getting out of a car, sneezing, coughing, or twisting suddenly.
• Trauma: You may suffer a blow to your spine that leads to a compression fracture after experiencing injuries or accidents like falls, car accidents, or other physical trauma.
• Cancer: Any cancerous tumor in your body can reach your spine and destroy the strength of your vertebrae, leading to your bones breaking.

What puts me at risk for a compression fracture?

You're more likely to experience a compression fracture if:

• You are assigned female at birth and have reached menopause.
• You have any form of condition that alters the strength of your bone.
• Age 50 or older.
• Have had a compression fracture previously.
• Research indicates that approximately 40% to 50% of individuals over age 80 had a compression fracture previously.

What are the long-term consequences of a compression fracture?

Potential long-term complications from a compression fracture include:

• Loss of normal curvature of your spine, creating a forward-curving deformity (kyphosis).
• You cannot control your bladder or bowels.
• You have chronic pain.
• Additional fractures.

How is a compression fracture diagnosed?

To diagnose a compression fracture, your healthcare provider will offer a physical examination to gain more information about your symptoms. Your healthcare provider will examine the following aspects during the exam:

• Your healthcare provider will examine your spine's alignment and check your height and posture.
• Your healthcare provider then gently applies pressure to different parts of your back to identify where your pain is coming from.
• Your healthcare provider will check for evidence of nerve damage, such as numbness, tingling sensation, or muscular weakness.

Your doctor will also guide you on the imaging tests to obtain pictures of the bones, muscles, and soft tissues in your back. The imaging studies include:

• Spine X-ray, CT scan, or MRI to demonstrate pictures of your spine and look for fractures and other injuries.
• DEXA scan is a specific X-ray that measures bone loss, commonly known as the bone density test.
• Myelogram: Your provider injects a contrast dye into your spinal column before doing a CT scan or X-ray. The dye makes images more evident.
• Three-phase bone scan: This is an imaging test that takes three sets of pictures during three different visits.
• Your provider may sometimes discover a compression fracture while doing another imaging test.

What is the best treatment for compression fractures?

Treatment for compression fracture focuses on the following:

• Easing pain.
• Stabilizing bones in your spine closely.
• Preventing another fracture.

Treatment may depend on the kind and extent of the fracture. This could be:

• Pain reliever medication: Your provider may advise over-the-counter NSAIDs, muscle relaxers, or prescription drugs. Take any prescribed medicines cautiously according to your provider's instructions.
• Braces: A high-tech type of back brace can help stabilize your vertebrae. It can also reduce your pain by minimizing the motions you make involving your spine. You will be asked to wear this brace for four to 12 weeks.
• Medicines to strengthen your bones: Anti-osteoporosis drugs called bisphosphonates can slow down further loss of your bones, stabilize them, and help prevent fractures.
• Physical therapy: A physical therapist can teach you stretch and exercises to strengthen the muscles around your spine.
• Surgery (vertebroplasty or kyphoplasty): Procedures that stabilize and support your vertebra with bone cement, typically done on an outpatient basis.

Can a compression fracture heal by itself?

Yes, some compression fractures will heal spontaneously. Healing may occur over several months. A healthcare provider can offer choices for treatment, which may include a brace, to ensure that your spine heals as desired. Let your provider know if you have symptoms interfering with your daily activities and mobility while healing.

Can compression fractures be prevented?

You cannot prevent all causes of compression fractures.

The most common cause is osteoporosis. To reduce your chances of having a compression fracture because of an osteoporosis issue, do this:

• Be injury and accident-proof. Eliminate hazardous tripping hazards. Use a seatbelt when traveling in an automobile.
• Take well-balanced meals. Ensure proper intake of vitamin D and calcium, which strengthen bones.
• Quit smoking and all tobacco products. Nicotine softens bones.
• See your doctor regularly and take medications as ordered to slow bone loss if you're at risk of osteoporosis.

What is the outlook for a compression fracture?

Your outlook after a compression fracture depends on

• The severity of the fracture.
• Your age.
• Your general health.
• Any underlying conditions that you have.
• Many compression fractures spontaneously heal with several months of bed rest and very little activity. Your physician may suggest alternative treatments to reduce the pain if the symptoms are unduly disturbing.
• If you have osteoporosis, you may be at risk of having another compression fracture. Your physician can direct you to the best management for osteoporosis and the resultant prevention of further fractures.

How long do compression fractures last?

Symptoms tend to disappear as the bones of your spine heal. They typically resolve on their own after approximately four weeks. Full recovery should be achieved within 12 weeks. Healing is subjective and varies based on a number of factors, such as age and the body's healing process.

What is the survival rate following a compression fracture?

Now, a compression fracture would be only one measure of how much life you have left, but it is certainly not the only thing your provider will consider when formulating your diagnosis. For example, a first-time vertebral compression fracture might suggest to a provider that the osteoporosis is progressing and has an increasingly greater impact on your body, even though otherwise you are relatively healthy.

You may or may not fit the statistics. Your healthcare provider is in the best position to guide you on what you might expect.

Living With

When should I see a healthcare provider?

Seek medical attention if you have an acute-onset back pain or other symptoms of a compression fracture that does not resolve within a few days. Be cautious about scheduling a specific time to see your provider if you have osteoporosis.

Call emergency services or seek immediate care at the emergency room if you suddenly experience severe back pain and:

• Are weak or numb.
• Have lost bladder or bowel control.
• Have a fever.

To seek an expert consultation for any orthopedic condition.

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