Your doctor will perform a physical exam. This may reveal:
A humpback, or kyphosis
Tenderness over the affected spinal bone or bones
A spine x-ray shows at least one compressed vertebra that is shorter than the other vertebrae.
Other tests that may be done:
A bone density test to evaluate for osteoporosis
A CT or MRI scan if there is concern that the fracture was caused by a tumor or severe trauma (such as a fall from a height or car accident)
Most compression fractures are seen in older people with osteoporosis. These fractures generally do not cause injury to the spinal cord. The condition is usually treated with medicines and calcium supplements to prevent further fractures.
Pain may be treated with:
Pain medicine, including narcotics
Other treatments may include:
Back braces, but these may further weaken the bones and increase your risk of more fractures
Physical therapy to improve movement and strength around the spine
A medicine called calcitonin to help relieve bone pain
Surgery may be done if you have severe and disabling pain for more than 2 months that does not get better with other treatments. Surgery can include:
Vertebroplasty done under local anesthesia and sedation.
Other surgery may be done to remove some bone if the fracture is due to a tumor.
After surgery you may need:
A brace for 6-10 weeks if the fracture was due to an injury
More surgery to join certain spine bones together or to relieve pressure on a nerve
Most compression fractures due to injury heal in 8 - 10 weeks with rest, bracing, and pain medications. However, recovery can take much longer if you had surgery.
Fractures due to osteoprosis usually become less painful with rest and pain medications, but some can lead to long-term (chronic) pain and disability.
Medicines to treat osteoporosis can help prevent future fractures. However, they cannot reverse damage that has already occurred.
For compression fractures caused by tumors, the outcome depends on the type of tumor involved. Some common tumors that involve the spine include:
Complications may include:
Failure of the bones to fuse after surgery
Spinal cord or nerve root compression
Calling your health care provider
Call your health care provider if:
You have back pain and you think you may have a compression fracture
Worsening symptoms or difficulty with controlling your bladder and bowel function
Treating and preventing osteoporosis is the most effective way to prevent these fractures.
Klazen CA, Lohle PN, de Vries J, et al. Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet. 2010 Sep 25;376(9746):1085-92.
Wardlaw D, Cummings SR, Van Meirhaeghe J, et al. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet. 2009;373(9668):1016-24.
David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery.