Syndromes, Injuries and Diseases
 
Vertebral Compression Fractures
What is a compression fracture of the vertebrae?

A compression fracture is crumbling or collapse of small sections of the bones of the spine that occurs without any obvious cause, such as an injury. The bones of the spine are called vertebrae. More of the crumbling happens in the front of the bone than the back, causing the spine to bend forward.

How does it occur?

Compression fractures in older adults are usually the result of osteoporosis. Osteoporosis causes bones to lose calcium and become more porous, thinner, and weaker. "Dowager's hump," a curving of the spine most often seen in older women, is caused by osteoporosis. About 20% of women have a compression fracture of the spine by age 70.

Osteoporosis develops over a period of years. Factors that increase the risk of developing osteoporosis include:

lack of regular, weight-bearing exercise
lack of sufficient calcium in your diet
being a woman past menopause who does not take hormone replacements
having a family history of osteoporosis
smoking
getting very little sunlight and not getting enough vitamin D from other sources
drinking a lot of alcohol
prolonged bed rest or immobility
some medicines, such as steroids.

What are the symptoms?

Symptoms occur only about half the time. The most common symptom is sudden, severe pain in the lower back or mid-back that may feel like a muscle spasm. The pain may extend throughout the back, hips, and legs. It can make moving or trying to walk very difficult. Many people recall the exact moment the pain started and what they were doing at the time. Often, the fracture occurs during routine chores such as making a bed, opening a door, or picking something up from the floor.

You may have a compression fracture without knowing it. It does not always produce severe pain or a change in the way your body works. Over time, compression fractures may cause you to become shorter by as much as several inches.

How is it diagnosed?

Your health care provider will ask about your symptoms and examine you. An x-ray is needed to confirm the diagnosis.

How is it treated?

Treatment for a compression fracture may consist of:

bed rest until your pain decreases, then increasing your level of activity gradually,
according to how much you feel you can do
wearing a corset or back brace to give the fractured area added support
taking medication for pain
physical therapy
vertebroplasty. This procedure is done in a hospital by an orthopedic surgeon. Needle
sticks are made in the spine and special cement is injected into the weakened
vertebrae. This process stiffens them and helps eliminate pain.

As your fracture heals, you will have less pain and will be able to do more. You may find assistive devices such as a cane or walker helpful in getting around. Avoid stretching or stooping to prevent further injury. When you feel pain in your back, stop what you are doing and apply either heat or cold, whichever feels better.

How can compression fractures be prevented?

Osteoporosis often runs in the family. Having a healthy lifestyle with a good diet that includes enough calcium and vitamin D and regular, weight-bearing exercise can help prevent or reduce the severity of osteoporosis. Speak with your health care provider about other ways of reducing your chances of developing it.

If you have osteoporosis, ask about treatment. For post-menopausal women, the most effective treatment is estrogen (hormone replacement therapy). In addition, there are some medications that appear to slow bone loss and help reduce fractures.

Using your body wisely when doing everyday tasks may help prevent compression fractures. For example:

Bend your legs rather than your back when you pick up something from the floor.
Hold objects close to your body when lifting them.
When getting out of a chair, put your weight over your feet and slide to the front of the
chair. Then, using the arms of the chair, raise yourself to a standing position.
Stop smoking.