What is a Spinal Compression Fracture

Spinal compression fracture is a collapse of the bones that form the spine (vertebrae). With this type of fracture, the vertebrae become pushed (compressed) into a wedge shape.

Most compression fractures happen in the middle or lower part of the spine.

What are the causes?

This condition may be caused by:

• Thinning and loss of density in the bones (osteoporosis). This is the most common cause.
• A fall.
• A car or motorcycle accident.
• Cancer.
• Trauma, such as a heavy, direct hit to the head or back.

What increases the risk?

You are more likely to develop this condition if:

• You are 60 years or older.
• You have osteoporosis.
• You have certain types of cancer, including:
  • Multiple myeloma.
  • Lymphoma.
  • Prostate cancer.
  • Lung cancer.
  • Breast cancer.

What are the signs or symptoms?

Symptoms of this condition include:

• Severe pain.
• Pain that gets worse over time.
• Pain that is worse when you stand, walk, sit, or bend.
• Sudden pain that is so bad that it is hard for you to move.
• Bending or humping of the spine.
• Gradual loss of height.
• Numbness, tingling, or weakness in the back and legs.
• Trouble walking.

Your symptoms will depend on the cause of the fracture and how quickly it develops.

How is this diagnosed?

This condition may be diagnosed based on symptoms, medical history, and a physical exam. During the physical exam, your health care provider may tap along the length of your spine to check for tenderness. Tests may be done to confirm the diagnosis. They may include:

• A bone mineral density test to check for osteoporosis.
• Imaging tests, such as a spine X-ray, CT scan, or MRI.

How is this treated?

Treatment for this condition depends on the cause and severity of the condition. Some fractures may heal on their own with supportive care. Treatment may include:

• Pain medicine.
• Rest.
• A back brace.
• Physical therapy exercises.
• Medicine to strengthen bone.
• Calcium and vitamin D supplements.

Fractures that cause the back to become misshapen, cause nerve pain or weakness, or do not respond to other treatment may be treated with surgery. This may include:

• Vertebroplasty. Bone cement is injected into the collapsed vertebrae to stabilize them.
• Balloon kyphoplasty. The collapsed vertebrae are expanded with a balloon and then bone cement is injected into them.
• Spinal fusion. The collapsed vertebrae are connected (fused) to normal vertebrae.

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 operate 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 brace as told by your health care provider. Remove it only as told by your health care provider.
• Loosen the brace if your fingers or toes tingle, become numb, or turn cold and blue.
• 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.

Managing pain, stiffness, and swelling

• If directed, apply ice to 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 30 minutes every two hours at first. Then apply the ice as needed.

Activity

• Rest as told by your health care provider.
  • Avoid sitting for a long time without moving. Get up to take short walks every 1–2 hours. This is important to improve blood flow and breathing. Ask for help if you feel weak or unsteady.
• Return to your normal activities as directed by your health care provider. Ask what activities are safe for you.
• Do exercises to improve motion and strength in your back (physical therapy), as recommended by your health care provider.
• Exercise regularly as directed by your health care provider.

General instructions

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

Contact a health care provider if:

• You have a fever.
• You develop a cough that makes your pain worse.
• 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:

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

Summary

• A spinal compression fracture is a collapse of the bones that form the spine (vertebrae).
• With this type of fracture, the vertebrae become pushed (compressed) into a wedge shape.
• Your symptoms and treatment will depend on the cause and severity of the fracture and how quickly it develops.
• Some fractures may heal on their own with supportive care. Fractures that cause the back to become misshapen, cause nerve pain or weakness, or do not respond to other treatment may be treated with surgery.