A compression fracture is a crumbling or collapse of small sections of the bones of the spine. The bones of the spine are called vertebrae. The crumbling or collapse tends to happen more in the front of the bone than the back. This makes you bend forward.
The medical name for this problem is vertebral compression fracture.
Compression fractures in older adults are usually caused by osteoporosis. Osteoporosis is a disease that thins and weakens bones to the point where they may break easily. It usually starts developing in women after menopause, between the ages of 45 and 55. Men tend to get the disease later in life, typically in the 70s.
Often, a compression fracture in older adults happens during routine chores, such as making a bed, opening a door, or picking something up from the floor. Sometimes, a cough or hard jolt in the car can cause the fracture. Younger adults can get a compression fracture from severe injury, such as in a car accident.
Adults of any age who take steroid medicine, such as prednisone, for a long time have a much higher risk for osteoporosis and compression fracture.
The most common symptom is sudden pain in the lower back or mid-back. The pain usually is moderate to severe. The pain may extend throughout the back, hips, and legs. It may get worse when you sit or stand. It can make it hard to move or walk. Many people recall the exact moment the pain started and what they were doing at the time.
You may have a compression fracture without knowing it. It does not always cause severe pain or a change in the way your body works. However, over time, compression fractures may make you shorter by as much as several inches.
In some cases, several compression fractures in the upper part of the back (the region between the shoulder blades) can lead to kyphosis of the spine, commonly known as dowager hump. However, not all people with this condition have compression fractures as the cause.
Your healthcare provider will ask about your symptoms and examine you. Your provider will look for where you have pain and what kinds of motions hurt. Your provider also will check for nerve problems in your arms and legs.
An X-ray of the spine is needed to confirm the diagnosis. Most fractures show up on simple front and side views of plain X-rays of the spine.
Depending on your symptoms and what the plain X-rays show, other tests may be done, such as:
Treatment for a compression fracture may include:
If you have severe pain that is not getting better, your healthcare provider may recommend vertebroplasty or kyphoplasty.
In several studies, vertebroplasty has been as good as kyphoplasty. Vertebroplasty can be done as an outpatient procedure and costs less because no balloon injection device is needed. These procedures can be of great benefit but they are not for everyone. Your healthcare provider can discuss the benefits and risks of this type of treatment with you.
If the compression fracture is causing vertebrae to press onto nearby nerves or the spinal cord, surgery may be needed.
As your fracture heals with treatment, you will have less pain and will be able to do more. Healing can take several months. Proper use of pain medicine with a gradual increase in activity is important.
There is a risk that you will have more fractures
Doing what you can to prevent osteoporosis can help prevent compression fractures. For example:
Talk to your healthcare provider about other ways to lower your risk of osteoporosis.
If you have osteoporosis, ask about treatment. There are several medicines that slow bone loss and help lower your risk of fractures.
Using your body wisely when doing everyday tasks may help prevent compression fractures. For example: