What is Lumbar Spine Fracture

Lumbar spine fracture is a break in one of the bones of the lower back. Lumbar spine fractures can vary from mild to severe. The most severe types are those that:

• Cause the broken bones to move out of place (unstable).
• Injure or press on the spinal cord.

During recovery, it is normal to have pain and stiffness in the lower back for weeks.

What are the causes?

This condition may be caused by:

• A fall.
• A car accident.
• A gunshot wound.
• A hard, direct hit to the back.

What increases the risk?

You are more likely to develop this condition if:

• You are in a situation that could result in a fall or other violent injury.
• You have a condition that causes weakness in the bones (osteoporosis).

What are the signs or symptoms?

The main symptom of this condition is severe pain in the lower back. If a fracture is complex or severe, there may also be:

• A misshapen or swollen area on the lower back.
• Limited ability to move an area of the lower back.
• Inability to empty the bladder (urinary retention).
• Loss of bowel or bladder control (incontinence).
• Loss of strength or sensation in the legs, feet, and toes.
• Inability to move (paralysis).

How is this diagnosed?

This condition is diagnosed based on:

• A physical exam.
• Symptoms and what happened just before they developed.
• The results of imaging tests, such as an X-ray, CT scan, or MRI.

If your nerves have been damaged, you may also have other tests to find out the extent of the damage.

How is this treated?

Treatment for this condition depends on how severe the injury is. Most fractures can be treated with:

• A back brace.
• Bed rest and activity restrictions.
• Pain medicine.
• Physical therapy.

Fractures that are complex, involve multiple bones, or make the spine unstable may require surgery. Surgery is done:

• To remove pressure from the nerves or spinal cord.
• To stabilize the broken pieces of bone.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drive or use heavy machinery while taking prescription pain medicine.
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
  • Take an over-the-counter or prescription medicine for constipation.

If you have a brace:

• Wear the back brace as told by your health care provider. Remove it only as told by your health care provider.
• Keep the brace clean.
• If the brace is not waterproof:
  • Do not let it get wet.
  • Cover it with a watertight covering when you take a bath or a shower.

Activity

• Stay in bed (on bed rest) only as directed by your health care provider.
• Do exercises to improve motion and strength in your back (physical therapy), if your health care provider tells you to do so.
• Return to your normal activities as directed by your health care provider. Ask your health care provider what activities are safe for you.

Managing pain, stiffness, and swelling

• If directed, put ice on the injured area:
  • If you have a removable brace, remove it as told by your health care provider.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.

General instructions

• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay healing after injury. If you need help quitting, ask your health care provider.
• Do not drink alcohol. Alcohol can interfere with your treatment.
• Keep all follow-up visits as directed by your health care provider. This is important.
  • Failing to follow up as recommended could result in permanent injury, disability, or long-lasting (chronic) pain.

Contact a health care provider if:

• You have a fever.
• Your pain medicine is not helping.
• Your pain does not get better over time.
• You cannot return to your normal activities as planned or expected.

Get help right away if:

• You have difficulty breathing.
• Your pain is very bad and it suddenly gets worse.
• You have numbness, tingling, or weakness in any part of your body.
• You are unable to empty your bladder.
• You cannot control your bladder or bowels.
• You are unable to move any body part (paralysis) that is below the level of your injury.
• You vomit.
• You have pain in your abdomen.

Summary

• A lumbar spine fracture is a break in one of the bones of the lower back.
• The main symptom of this condition is severe pain in the lower back. If a fracture is complex, there may also be numbness, tingling, or paralysis in the legs.
• Treatment depends on how severe the injury is. Most fractures can be treated with a back brace, bed rest and activity restrictions, pain medicine, and physical therapy.
• Fractures that are complex, involve multiple bones, or make the spine unstable may require surgery.