Treating and preventing a compression fracture of the spine

A compression fracture is a break in which the bone collapses. It can be caused by an injury or tumors in the spine, but most compression fractures happen because of osteoporosis, a disease that causes bones to weaken over time.

The most common compression fracture in people with osteoporosis is a spinal compression fracture, also known as a vertebral compression fracture. This kind of injury affects the vertebrae, the small bones along the spine. Spinal compression fractures happen when there's too much pressure on a fragile vertebra, causing the front of the bone to crack and collapse.

Often, people with osteoporosis experience a spinal compression fracture when they fall down, but fractures can happen during everyday activities, such as reaching into a cabinet, twisting during bathing, or sneezing.

Mild compression fractures can cause minimal pain and a few other minor symptoms, but more severe fractures can be extremely painful and damage the spinal cord.

Both men and women can have a vertebral compression fracture, but women are at a much higher risk. About 25% of postmenopausal women in the U.S. will have at least one fracture -- which, in turn, increases the risk of having another. More than 30% of people who have a compression fracture of the spine will likely have another within a year.

Signs and symptoms of a compression fracture

Some spinal compression fractures happen slowly. Small cracks can appear in the vertebrae and become larger over time until the bone collapses. You might not know you have a fracture until it's seen during a chest or spinal X-ray.

These slowly occurring compression fractures of the spine often come with long-term symptoms including:

• A stooped posture known as kyphosis
• Increased pain when sneezing or coughing
• Loss of height
• Minor back pain that feels worse with movement, especially standing or walking
• Tenderness around the fractured bone

Other spinal compression fractures can happen suddenly and cause severe, stabbing pain that can last for weeks or months. This pain is usually felt in the middle or lower back, or sometimes on the sides or the front of the spine.

Compression fractures that happen suddenly or slowly form over time can both become severe by putting extra pressure on the spinal cord and nerves running down the spine. When this happens, you might also have:

• Difficulty walking
• Loss of bladder or bowel control
• Numbness or tingling in the lower body
• Weakness

Diagnosing and detecting a compression fracture

Diagnosing a vertebral fracture starts with a physical exam, during which your provider will ask questions about your symptoms and medical history. You will likely need to stand so your provider can see if your spine is straight, curved, or stooped. They might also press different parts of your spine to help find the location and cause of your pain, check for weakness or loss of sensation in your lower body, and examine your reflexes.

If your provider thinks you might have a spinal compression fracture -- or if they want to rule out other possible conditions -- they can order imaging to get a clearer picture.

Your provider might order a dual-energy X-ray absorptiometry (DEXA) scan, a test that checks your bone density. From the results, your provider will be able to see if you have osteoporosis and how severe it is. This will help to decide which treatment options are best for you.

Compression fracture treatment

Most compression fractures heal within eight to 10 weeks with rest and pain medication. Your provider might also recommend a back brace.

Physical therapy is often ordered to help strengthen the core muscles to support the spine. A physical therapist might work with you on balance and posture to help prevent future falls.

Surgery might be needed if you continue to have significant pain or other symptoms for more than two months after starting nonsurgical treatments. Your provider may recommend an open spinal surgery or minimally invasive spinal surgery depending on your symptoms and other factors.

Preventing compression fractures

The most important way to prevent compression fractures is to prevent and treat osteoporosis. It's not possible to reverse the damage, but you might be able to help slow or prevent worsening osteoporosis with the following:

• Do routine, weight-bearing exercises
• Don't smoke
• Eat a healthy diet
• Limit alcohol
• Take prescribed medication to help prevent and treat osteoporosis

Using fall prevention strategies and participating in exercises can decrease your risk of falls and lower your risk of another compression fracture.

The specialists at Reid Health Comprehensive Bone & Joint Center are here for you. Request an appointment to learn more about how we can help lower your risk of fractures and keep you healthy and active.