Compression Fracture of the Back

Compression fractures caused by back injuries can be very painful. It may feel as though someone is stabbing a knife into your back. Fractures caused by osteoporosis may cause you more pain when you are standing than when you are lying down. These fractures may also cause you to stoop over, develop a hump on your back (kyphosis), and lose up to 6 inches in height as your vertebrae compress.

The following symptoms are rare, but they are caused by pressure on your spinal chord due to poor posture:

• numbness or tingling in your limbs or other areas of your body
• difficulty walking and moving around
• incontinence

Osteoporosis is a condition that causes thinning of the bone tissue and loss of bone density. It’s the most common cause of compression fractures of the back. It usually affects older adults.

Other possible causes of compression fractures of the back include:

• physical trauma to your back
• a tumor that either originates in your spine or a tumor that spreads to your spinal area (relatively rare)
• congenital disease such as osteogenesis imperfecta
• infection (osteomyelitis) of the vertebra

The following people are at a high risk for a compression fracture of the back:

• women, especially those who have gone through menopause
• older men, particularly those over 60
• people with a calcium deficiency

Your doctor will first examine you to see if your spine is curved or if you have developed a hump on your back. The doctor will then use a CT scan, an MRI, an X-ray, or a bone density test to check for osteoporosis. These same studies help diagnose compression fractures except bone density testing.

Tumors that may be responsible for a compression fracture can show up in diagnostic imaging tests, as can traumatic injuries to your back.

If the underlying cause of your compression fracture is osteoporosis, your doctor may recommend:

• pain medications
• bed rest to help your body heal
• physical therapy to help strengthen your core muscles and spinal support muscles
• a back brace, which can help support your spine
• calcium supplements to prevent additional bone problems and future compression fractures
• medications to induce new bone formation
• surgical treatment to restore the height of the vertebra and insertion of bone cement to prevent the vertebra from collapsing (vertebroplasty and kyphoplasty).

If a tumor has caused your compression fracture, more invasive treatments may be used, including:

• surgery to remove sections of bone or tissue
• lengthening your spine by injecting a special kind of cement (vertebroplasty) into the space between your vertebrae

If your fractures are caused by a back injury, your surgeon may need to fuse some of your vertebrae together to relieve pain and pressure on your nerves.

Many people with osteoporosis are able to live without high levels of back pain if they rest and take pain medication as needed. It isn’t possible to reverse bone damage from osteoporosis, but taking calcium supplements, not smoking, and taking medication to strengthen your bones can help protect against future breaks.

If an injury caused your compression fracture, recovery can take eight to 10 weeks or longer. You may need to wear a back brace and get plenty of bed rest. If a tumor caused your fracture, the underlying cause of the tumor (lung cancer, for example) must be treated and the tumor removed. Your outlook will depend on the type of tumor that caused your condition.