Compression Fracture

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is a compression fracture?

The bones in your spine are called vertebrae, and when a vertebra collapses, it’s called a vertebral compression fracture. The spine is divided into sections, with seven cervical (neck) vertebrae, 12 thoracic (middle back) vertebrae, and five lumbar (lower back) vertebrae. The last thoracic vertebra (T12) and the first lumbar vertebra (L1) are the most likely to suffer a compression fracture because they bear the most weight. A T12 or L1 compression fracture most commonly happens as a wedge fracture, which occurs when the front part of the vertebra collapses and the back doesn’t, making the bone look like a wedge.

Osteoporosis, which causes decreased bone density, is a common risk factor for compression fractures. Women are typically more prone to compression fractures than men.

If you have a sudden, high-impact injury, you will feel severe pain in your back as well as your arms and legs. This could indicate a compression fracture. If you have osteoporosis, you may not notice symptoms at first. Later, you may feel pain when you walk and be noticeably shorter or have a stooped posture.

Compression fracture treatment options vary depending on the cause. Nonsurgical options include activity restrictions, physical therapy, and treating osteoporosis. Your doctor may recommend surgery if an injury caused the fracture. Left untreated, you could develop such advanced stooped posture that you appear to have a ‘humpback.’ If you suffer a sudden, severe back injury, call 911 for immediate medical attention.

What are the symptoms of a compression fracture?

Compression fracture symptoms depend on what caused the break, such as:

  • Back injury. If a sudden, severe back injury caused the fracture, you’ll feel intense, sharp pain, usually in the middle or lower part of your back. You could also feel pain in your arms and legs. If you damaged your spinal cord (or the nerve roots extending from the spinal cord) during the injury, you might feel numb, weak or tingly in your arms and legs.

  • Thinning bones. If osteoporosis is the cause of the compression fracture, you might not notice symptoms right away. As the compression fracture worsens, you might gradually begin to feel pain. Without treatment, osteoporosis will progress over time and might slowly cause you to lose up to six inches in height and develop a humpback from stooped posture.

A sudden, severe back injury calls for a visit to your doctor or possibly the emergency room. Call 911 if you are alone or do not have transportation to get to a medical facility.

If you have been diagnosed with osteopenia or osteoporosis or you’re at high risk for the condition, visit your doctor regularly. Together, you can work on a plan to protect your spine and help prevent a compression fracture.

What causes compression fractures?

Osteoporosis is a common cause of compression fractures, especially in older people. If you have osteoporosis, you’ll lose bone density, making your bones more fragile and prone to breaks. Weak bones are more at risk of suffering a compression fracture. If you have advanced osteoporosis, even the normal act of bending forward can cause compression fractures.

A severe back injury can also cause a compression fracture, even in people with healthy bones. Such an injury can result from a fall or car crash. A tumor or infection can also cause compression fractures, although this is less common.

What are the risk factors for getting a compression fracture?

Postmenopausal women have the highest risk of getting a compression fracture because they are most likely to be affected by osteoporosis. Compression fractures rarely happen in people with healthy bones unless the person has a spinal tumor or suffers trauma to the back.  

Reducing your risk of compression fractures

While you can’t change your gender or your age, you can take care of your bones to help prevent osteoporosis. Strengthen your bones by doing weight-bearing exercise, such as walking, and make sure your diet includes enough calcium and vitamin D. It’s especially important for women—even before menopause—to talk with a doctor about the best ways to prevent osteoporosis. Your doctor may want you to take calcium supplements or have a bone density test to check for the condition. Take the same actions if you have a family history of osteoporosis or compression fracture, regardless of gender.

How is a compression fracture treated?

Most of the time, healthcare professionals recommend nonsurgical treatment for a compression fracture. You may need to take over-the-counter pain relievers and limit your activity for a while. Elderly people may even go on bed rest to reduce the risk of complications from a compression fracture.

Do not strain the spine with strenuous exercise or heavy lifting. However, your doctor may recommend physical therapy to rehabilitate your bones. Doctors also prescribe back braces to limit movement and support the back while it heals. A back compression fracture can take about three months to heal.

While it’s rare, surgery may be necessary to repair a compression fracture. There are several types of surgical treatments, including:

  • Kyphoplasty in which a small balloon is inflated to lift the vertebra and a special cement fills the space to stabilize the fracture

  • Vertebroplasty, which is like kyphoplasty, except surgeons don’t use a balloon for vertebroplasty

  • Spinal fusion in which a surgeon puts a bone graft across the fracture and uses screws and rods to hold the vertebrae together while the fracture heals

  • Spine surgery to remove a spinal tumor and repair the vertebral fracture if necessary

If poor bone density is an underlying cause of the compression fracture, be sure to talk with your doctor about treating that condition as well.

What are the potential complications of a compression fracture?

Young and elderly patients can all experience complications from a compression fracture. Some of these complications include:

  • Kyphosis—also called a ‘dowager’s hump’—can look like a humpback and may result after someone suffers many compression fractures

  • Spinal cord compression or damage of the nerve root

  • Comorbid conditions, such as pneumonia or blood clots, which become more of a problem with bed rest or inactivity

Complications of surgical compression fracture treatment are also possible, such as incomplete fusion, blood clots, wound infection, problems with anesthesia, and damage to nearby nerves, blood vessels, or tendons in the back.

If your doctor recommends surgery, keep in mind there is usually more than one option to deal with a compression fracture. It’s important to learn about the options for your specific situation, including its benefits and risks, so you can be confident with your treatment choice.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 21
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