Compression Fracture

A compression fracture is a type of bone break that occurs when a vertebra in the spine collapses, often due to excessive pressure or weakening of the bone. It is most commonly seen in individuals with osteoporosis, but it can also result from trauma, such as a fall or accident.

Symptoms may include back pain, loss of height, and a hunched posture. Treatment options vary depending on severity and may include pain management, physical therapy, bracing, or surgical procedures like vertebroplasty or kyphoplasty to stabilise the spine.

Causes of a Compression Fracture

These are the main causes.

Osteoporosis

One of the most common causes of compression fractures is osteoporosis, a condition that weakens bones, making them more susceptible to fractures. As bone density decreases, even minor stresses like bending or lifting can lead to a vertebral collapse.

Trauma and Injury

High-impact accidents, such as car crashes, falls, or sports injuries, can exert excessive force on the spine, leading to a compression fracture. This type of fracture is more common in younger individuals who have strong bones but experience sudden, intense pressure on their vertebrae.

Cancer and Tumors

Certain cancers, especially those that spread to the bones, can weaken the vertebrae and increase the risk of compression fractures. Tumors may erode the bone structure, reducing its ability to support normal spinal function.

Long-Term Steroid Use

Prolonged use of corticosteroids can lead to bone loss, increasing the likelihood of fractures. These medications can interfere with bone formation and contribute to osteoporosis, making the spine more vulnerable to compression fractures.

Age-Related Degeneration

As people age, natural wear and tear on the spine can weaken the vertebrae. Degenerative changes in the discs and bones may reduce spinal stability, leading to an increased risk of fractures even without significant trauma.

Types of Compression Fractures

These are the common types of compression fractures.

Wedge Fracture

A wedge fracture occurs when the front part of a vertebra collapses while the back remains intact, creating a wedge-shaped deformity. This is the most common type of compression fracture and is often associated with osteoporosis. It can lead to a forward-curved posture known as kyphosis if multiple fractures occur.

Crush Fracture

In a crush fracture, the entire vertebra collapses rather than just the front portion. This type of fracture results in significant height loss of the vertebra and may cause severe pain and spinal instability. It is more likely to occur in cases of severe bone weakening due to osteoporosis or metastatic cancer.

Burst Fracture

A burst fracture occurs when the vertebra breaks in multiple places and fragments spread outward. This type of fracture is usually caused by high-energy trauma, such as a car accident or a fall from a significant height.

Because bone fragments can press on the spinal cord, a burst fracture may lead to neurological complications, including numbness, weakness, or paralysis.

Symptoms of a Compression Fracture

Sudden or Gradual Back Pain

Compression fractures can cause sharp, sudden pain if they result from trauma or develop gradually with a dull ache if caused by osteoporosis. The pain is often localised to the mid or lower back and may worsen with movement, standing, or lifting.

Height Loss

Multiple compression fractures can lead to a noticeable reduction in height over time. As the vertebrae collapse, the spine shortens, causing an overall decrease in stature.

Spinal Deformity

A forward-curving posture, known as kyphosis or a “hunchback” appearance, can develop when several vertebrae are affected. This occurs due to the wedge-like shape of the fractured bones, altering spinal alignment.

Limited Mobility

Movement can become restricted due to pain and spinal instability. Individuals may find it difficult to bend, twist, or stand for long periods, leading to reduced physical activity.

Neurological Symptoms

In severe cases, fractured vertebrae can press on spinal nerves, causing symptoms such as numbness, tingling, or weakness in the legs. If the spinal cord is compressed, there may be a risk of paralysis or loss of bladder and bowel control.

Treatment for a Compression Fracture

This is how you treat a compression fracture.

Pain Management

Medications such as over-the-counter pain relievers, anti-inflammatory drugs, and muscle relaxants can help reduce discomfort. In more severe cases, doctors may prescribe stronger pain medications or nerve-blocking injections to provide relief.

Rest and Activity Modification

Limiting physical activity and avoiding heavy lifting can prevent further strain on the spine. Short-term bed rest may be recommended in acute cases, but prolonged inactivity should be avoided to prevent muscle weakness and worsening bone loss.

Bracing and Support

A back brace can provide stability and reduce movement in the affected area, allowing the vertebrae to heal properly. This is especially useful for individuals with multiple fractures or those at risk of spinal deformity.

Physical Therapy

Targeted exercises and rehabilitation programs can strengthen the back muscles, improve posture, and restore mobility. Physical therapy helps reduce pain and prevents future fractures by enhancing spinal support and flexibility.

Surgical Interventions

In cases where pain persists or the fracture causes spinal instability, minimally invasive procedures such as vertebroplasty or kyphoplasty may be performed. These procedures involve injecting bone cement into the fractured vertebra to stabilise and restore its height, reducing pain and preventing further collapse.