Compression Fracture

A compression fracture is a break in one of the vertebrae, the small bones that make up your spine.  These fractures can cause sudden or chronic back pain, height loss, and a hunched posture. Fortunately, with the right medical treatment, most patients can recover and reduce their risk of future fractures.

What Causes Compression Fractures?

The most common cause of compression fractures is osteoporosis, a chronic condition that weakens bones over time, making them more likely to break. Other causes include:

• Spinal trauma from a fall, accident, or injury
• Metabolic disorders like Paget's disease and hyperparathyroidism
• Long-term steroid use
• Cancer that spreads to the spine and weakens the bones

Older adults, especially postmenopausal women, are at higher risk for compression fractures.

What Are the Symptoms of a Compression Fracture?

Compression fractures may develop suddenly or gradually. Common symptoms include:

• Sudden sharp back pain, often after bending or lifting
• Pain that worsens with standing or walking but improves when lying down
• Focal tenderness to palpation along the affected region
• Loss of height over time
• A stooped or hunched posture may occur with multiple compression fractures

Some mild fractures may cause no symptoms and go unnoticed until discovered on an X-ray.

When Should I See a Specialist?

You should seek medical care if you experience:

• Sudden, severe back pain
• Back pain after a fall or accident
• Loss of height or stooped posture
• Pain that doesn't improve with rest or over-the-counter medication

How Are Compression Fractures Diagnosed?

A doctor will diagnose a compression fracture by:

• Reviewing your medical history and symptoms
• Performing a physical exam to check for spinal tenderness or posture changes
• Ordering imaging tests such as:
  • X-rays to confirm the fracture
  • MRI or CT scans to assess the extent of the fracture
  • Bone density tests (DEXA scan) if osteoporosis is suspected
  • Laboratory workup may be sent to rule out other conditions

How Is a Compression Fracture Treated?

Treatment depends on the cause and severity of the fracture, age, and overall health. Many osteoporotic compression fractures heal with nonsurgical care, but some require minimally invasive procedures.

Nonsurgical Treatments 

Most osteoporotic compression fractures are treated non-operatively. Nonsurgical treatments include:

• Rest and activity modification
• Back bracing to limit motion and may support healing
• Oral Pain medications
• Bone-strengthening medications for osteoporosis

These treatments aim to relieve pain, stabilize the spine, and prevent future fractures.

Surgical Treatments 

Surgery may be recommended if:

• Pain is severe or doesn't improve with nonsurgical care
• There is spinal instability or progressive neurologic deficit

Minimally invasive surgical options include:

• Vertebroplasty: Bone cement is used to stabilize and strengthen the fractured vertebra.
• Kyphoplasty: A balloon is used to restore vertebral height before injecting bone cement.

These treatments are often outpatient procedures (meaning you can go home the same day) and provide rapid pain relief.

What Are the Risks of Compression Fracture Surgery?

While generally safe, surgical procedures come with risks, such as:

• Infection
• Bleeding
• Neurologic deficit
• Allergic reaction to anesthesia or bone cement
• Cement leakage, which could irritate nerves or other tissues
• Rare cases of new fractures in nearby vertebrae

Your surgeon will explain these risks and help determine the best treatment plan for you.

What Does Recovery from a Compression Fracture Surgery Involve?

Recovery includes a combination of rest, pain control, and physical therapy. You may:

• Wear a brace for support
• Take medication to manage pain
• Begin gentle exercises to rebuild strength and flexibility
• Learn safe movement techniques to protect your spine

Follow-up care to monitor healing and bone health is an important part of recovery.

How Long Does Recovery Take?

Recovery depends on the severity of the fracture and treatment type:

• Nonsurgical recovery: May take 6 to 12 weeks
• Surgical recovery: Some patients feel better within days, but full healing may take several weeks

Avoid heavy lifting or twisting movements until your doctor clears you.

What Is the Outlook for Compression Fractures?

With early treatment, many fractures fully recover without surgery. The outlook for compression fracture surgery is generally good, with many patients experiencing an immediate reduction in pain. But outcomes depend on a number of factors, including age, bone density, overall health, and the type of fracture.