Compression Fracture: Not Just Ordinary Back Pain

There are three main types of compression fractures:

• Burst — This severe spinal fracture causes bone pieces to spread in multiple directions.
• Crush — This fracture is in the entire vertebra. The bone collapses on itself.
• Wedge — This fracture forms in the front of a vertebra. The broken bone collapses, creating a wedge shape.

Spinal Compression Fracture: Causes and Risk Factors

"Compression fractures are common because your bones naturally weaken as you age,” said Dr. Lee. Osteoporosis — a disease that weakens bones and makes them brittle — is the most common cause of compression fractures. They may also occur due to sudden trauma, such as bad falls or car accidents. Certain types of cancer and tumors affecting the spine can also cause compression fractures. 

The risk of compression fractures increases with age, especially for people over the age of 50. Other risk factors include:

• Being female and having been through menopause
• Having a condition that affects your bone strength
• Having more than two drinks a day (women) or more than three drinks a day (men)
• Lack of physical activity
• Previously having a compression fracture
• Smoking
• Vitamin D deficiency

You can reduce your risk for compression fractures by eating a diet rich in calcium and vitamin D to strengthen your bones. You can also take medication to prevent bone loss as prescribed by your physician. Other steps you can take to reduce your risk include:

• Avoiding excessive drinking
• Protecting yourself from injuries and accidents, including wearing a seatbelt when driving
• Quitting smoking

Compression Fracture Symptoms

The symptoms of a compression fracture range from mild to severe. You may not notice symptoms with mild fractures. Symptoms of a compression fracture may include:

• Limited mobility
• Loss of height and spinal deformities (hunched posture)
• Muscle weakness or spasms
• Sudden sharp back pain that gets worse when you move or stand
• Numbness, tingling or weakness in extreme cases if the fracture affects a nerve

How serious is a compression fracture of the spine?

Mild compression fractures may cause some discomfort but can heal with conservative treatment. However, severe fractures can cause long-term pain, deformity and nerve damage without proper treatment. Complications from untreated compression fractures include:

• Blood clots in the legs due to reduced mobility
• Fractured bones that do not heal after treatment
• Kyphosis (excessive rounding of the upper back)
• Nerve or spinal cord problems

Compression Fracture Treatment Options

Some fractures can heal on their own, but it may take several months. Most compression fractures can be treated with nonsurgical treatments, including:

• Activity modification — You may need to avoid certain activities, such as high-impact sports, bending and lifting, while the fracture heals. Although rest is important, low-impact activities like walking can help increase blood flow to the fracture and help it heal faster.
• Braces — A back brace can support the vertebra and reduce how much you move your spine, which can help relieve pain. You may need to wear the brace every day until the fracture heals.
• Medication — Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, can help relieve pain. If your pain persists, your physician may prescribe a stronger pain reliever.
• Physical therapy — Physical therapy can help you strengthen your back muscles and improve your posture. A physical therapist can also teach you exercises to help you sit, stand and walk.

If you have a more serious fracture, your physician may recommend surgery to stabilize it. Minimally invasive surgeries for severe compression fractures include:

• Kyphoplasty — This procedure uses a balloon-like device to make the vertebra taller, filling the empty space with a special cement.
• Vertebroplasty — This procedure uses a surgical cement to hold your bones in place and prevent them from collapsing.

If you have a severe fracture or persistent pain, your physician may recommend spinal fusion surgery as a last resort. Spinal fusion connects two or more vertebrae together with metal screws to keep them from moving. However, this can limit your movement since it eliminates the natural movement of the fused vertebrae.

Compression Fracture Recovery: What to Expect

Recovery from compression fracture surgery depends on the type of procedure, severity of the fracture and your overall health

With kyphoplasty and vertebroplasty, most people feel relief from back pain within 24 to 48 hours after surgery. Some may take up to three days to feel better. Your physician will encourage you to resume your normal activities as soon as possible, but will ask you to avoid strenuous exercise or heavy lifting that can cause reinjury.

Recovery is longer if you have spinal fusion surgery. You will likely need to stay in the hospital for five days after the surgery. Full recovery depends on your age and health but can take two to six months.

Your pain levels will usually decrease after surgery, but some discomfort is normal. Over-the-counter pain medication can help. You will have a follow-up appointment within the first few weeks to make sure the fracture is healing properly. You may also need physical therapy to strengthen your back muscles and improve your flexibility and mobility.

If you have sudden back pain or symptoms that do not resolve in a couple of days, call your physician. Go to the emergency room if you have severe sudden back pain and:

• Fever
• Loss of bladder or bowel control
• Weakness or numbness

Find the Care You Need

Compression fractures can have a significant impact on your spinal health. Recognizing the symptoms early, such as sudden or worsening back pain, is critical for preventing further complications. Many fractures will heal on their own over time. But if you need treatment, your physician can work with you to create a plan that works for you.