What You Should Know About Spinal Compression Fractures

A spinal compression fracture occurs when the vertebral body in the front of your spine gets compressed due to axial loading. Underlying medical conditions, such as osteoporosis and spinal tumors are common causes for these fractures. ¹ Waldman S. Thoracic Vertebral Compression Fracture. In: Atlas of common pain syndromes. Elsevier; 2019:282-285. Available at: https://www.sciencedirect.com/science/article/pii/B9780323547314000736

This blog highlights the essentials of spinal compression fractures and how they can contribute to middle or lower back pain.

Spinal compression fractures can be spontaneous.

Conditions such as osteoporosis or spinal tumors can weaken the vertebrae in your spine. Once the bone has weakened, it may no longer be able to support your spinal column as you go about your daily activities. In these cases, compression fractures may occur spontaneously when you perform everyday activities, such as ² Bishop MD, Lentz TA, George SZ. Low Back Pain. In: Pathology and Intervention in Musculoskeletal Rehabilitation. Elsevier; 2016:471-501. doi:10.1016/b978-0-323-31072-7.00012-9 :

• Opening a window
• Coughing or sneezing
• Lying in bed

Osteoporotic compression fractures can become recurrent, affecting several vertebrae after the first incident. ³ Donnally III CJ, DiPompeo CM, Varacallo M. Vertebral Compression Fractures. [Updated 2019 Oct 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448171/

It is also possible for compressive spinal fractures to occur as a result of high energy trauma, such as from falls or motor vehicle accidents. ³ Donnally III CJ, DiPompeo CM, Varacallo M. Vertebral Compression Fractures. [Updated 2019 Oct 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448171/

See When Back Pain Is a Spine Compression Fracture

Compression fractures are common in the middle and lower back.

While a compression fracture can occur anywhere along your spine, the most common areas are in the thoracic and lumbar vertebrae.

• 60% to 75% of vertebral compression fractures typically occur at the T12 to L2 vertebral levels—your middle back area. ³ Donnally III CJ, DiPompeo CM, Varacallo M. Vertebral Compression Fractures. [Updated 2019 Oct 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448171/
• 30% of vertebral compression fractures may occur at the L2 to L5 vertebral levels—your lower back area. ³ Donnally III CJ, DiPompeo CM, Varacallo M. Vertebral Compression Fractures. [Updated 2019 Oct 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448171/

These fractures are relatively rare in the neck or upper back. A compression fracture often results in a wedge-shaped vertebral body. This shape is the result of the front of the vertebral bone collapsing (or compressing), while the back of the bone remains unchanged. ³ Donnally III CJ, DiPompeo CM, Varacallo M. Vertebral Compression Fractures. [Updated 2019 Oct 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448171/

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Spinal compression fractures may cause localized or radiating pain.

Pain and dysfunction from spinal compression fractures typically depend on the number of vertebrae affected and the involvement of any surrounding nervous tissue.

Compression of the vertebra(e) typically causes ¹ Waldman S. Thoracic Vertebral Compression Fracture. In: Atlas of common pain syndromes. Elsevier; 2019:282-285. Available at: https://www.sciencedirect.com/science/article/pii/B9780323547314000736 :

• A dull, deep ache in the region of the fracture.
• Increased pain when the area of the fracture is touched or gently pressed.
• Sudden pain when you take a deep breath, cough, sneeze, and/or move your spine in certain directions.

If the fracture occurs from a traumatic injury, the skin over the affected vertebra may appear red.

If the compressed vertebra impinges on a nearby spinal nerve root, one or more of the following additional symptoms and signs may occur ¹ Waldman S. Thoracic Vertebral Compression Fracture. In: Atlas of common pain syndromes. Elsevier; 2019:282-285. Available at: https://www.sciencedirect.com/science/article/pii/B9780323547314000736 :

• A sharp, severe, stabbing pain at the region of the fracture
• Shooting pain that radiates into the arm(s) or leg(s)
• Difficulty in walking

Read more about Vertebral Fracture Symptoms

In severe cases, vertebral compression fractures may cause complications related to the spinal cord.

Compression fractures of the spine are typically treated with rest, bracing, heat and/or cold therapy and pain-relieving medication. ¹ Waldman S. Thoracic Vertebral Compression Fracture. In: Atlas of common pain syndromes. Elsevier; 2019:282-285. Available at: https://www.sciencedirect.com/science/article/pii/B9780323547314000736 In more severe cases, compression fractures are treated with kyphoplasty, which is a minimally invasive procedure.

See Compression Fracture Treatment

If you experience any of the above symptoms or suspect a spinal compression fracture, consult a doctor for a complete diagnostic check-up and treatment. A doctor can help conduct the necessary medical tests and formulate an accurate treatment plan for your compression fracture.

Learn more:

Diagnosing Vertebral Compression Fractures

Multiple Compression Fractures