A compression fracture occurs when one or more bones in the spine (vertebrae) collapse. While this can happen due to high-impact trauma, it is most frequently caused by osteoporosis, a condition that weakens bones and makes them brittle. In severe cases of osteoporosis, simple actions like sneezing, reaching, or stepping out of a bathtub can cause the front of a vertebra to crack and flatten into a wedge shape.
The symptoms of a compression fracture can be sudden and sharp or develop as a chronic, dull ache.
Sudden Back Pain: Intense pain that often starts abruptly during a minor physical activity.
Pain with Standing: Discomfort that typically increases when standing or walking and decreases when lying down.
Loss of Height: As vertebrae collapse and flatten, the individual may become measurably shorter over time.
Kyphosis: A forward curvature of the spine that occurs when multiple vertebrae collapse into wedge shapes, causing the back to hunch forward.
Limited Spinal Mobility: Difficulty twisting or bending the torso.
Nerve Compression: If the bone fragments push into the spinal canal, it can cause numbness, tingling, or weakness in the limbs.
Because these fractures are often mistaken for general back pain or aging, clinical imaging is necessary for confirmation.
Physical Examination
X-rays: The primary tool used to identify a loss of vertebral height or a wedge-shaped deformity.
MRI: Essential for determining the age of the fracture. It shows bone edema (swelling), which indicates the fracture is recent and still healing.
CT Scan: Provides a detailed look at the bone structure to see if the fracture is stable or if bone fragments are near the spinal cord.
Treatment focuses on managing pain, stabilizing the bone, and addressing the underlying cause of bone weakness.
Pain Management: Using NSAIDs or specialized nerve pain medications to manage the acute phase of healing.
Bracing: A back brace may be used to limit movement and support the spine while the bone knits back together.
Activity Modification: Avoiding heavy lifting or strenuous twisting, but maintaining gentle walking to prevent further bone loss.
Kyphoplasty or Vertebroplasty: Minimally invasive surgical procedures where a balloon is used to restore height (kyphoplasty) and medical-grade bone cement is injected to stabilize the fracture.
Osteoporosis Treatment: Medications such as bisphosphonates or bone-building drugs to strengthen the rest of the skeleton and prevent future fractures.
Physical Therapy: Focusing on back extension exercises to strengthen the muscles that support the spine and improve posture.