What are the Signs of a Compression Fracture?
Author: Dr. Hamid Abbasi
DATE: 12 Jun 2019
Back Pain & Injuries
Could a compression fracture be causing the back pain that you are suddenly feeling? Compression fractures become more common as we age. Many are never diagnosed, so it is important to know the signs.
What is a Compression Fracture?
Compression fractures usually occur because the bones in the spine have become brittle and weak. Over time, tiny cracks or hairline fractures begin to appear in one or more weakened vertebrae. When several of these small fractures occur, the vertebrae will collapse because they can no longer support the weight that the spine must carry. The result is a spinal compression fracture. Compression fractures usually occur in the lower back but they can occur in any part of the spine.
Most compression fractures affect the front part of the vertebra, so it is the front part that collapses. When this happens, the spine begins to curve forward. The result is a stooped posture—one that causes a person to bend forward. This is commonly known as dowager’s hump or kyphosis in medical terms. The person can also become a little shorter as the vertebrae in the spine compress.
You are more likely to experience a compression fracture as you age. People who are age 65 or older now make up the fastest growing segment of the US population. With more and more people entering this age bracket, it becomes more likely that the number of compression fractures will increase.
What are the Symptoms of a Compression Fracture?
About two thirds of spinal compression fractures are never diagnosed because many patients simply write off the pain to arthritis or old age and don’t seek medical help. So it’s important to be aware of how compression fractures happen and the symptoms that they cause.
Some people have only minor symptoms. Some people have no symptoms at all. Common symptoms of a compression fracture include:
- back pain that comes on suddenly
- pain that is worse while standing or walking but better when lying on your back
- an inability to move your spine freely
- a loss of height
- numbness, tingling, or weakness
Many people first experience pain from a compression fracture after performing just a simple everyday task, such as opening a window or lifting a grocery bag. The pain usually lasts for a few weeks or longer. Eventually, it lessens and becomes more of an ache.
Causes of Compression Fractures
Osteoporosis is the most common cause of compression fractures. Compression fractures caused by osteoporosis occur in about 700,000 people in the US each year. Unfortunately, anyone who has had a compression fracture because of osteoporosis is at five times the risk of having another one.
For women, the risk of developing osteoporosis increases after menopause. Not surprisingly, so does the incidence of compression fractures. About 25 percent of postmenopausal women have suffered a compression fracture. Risk increases with age. Women age 80 and older have a 40-percent chance of having a compression fracture. In older women with severe osteoporosis, just coughing or sneezing is enough to cause a vertebra to fracture.
One of the challenges of preventing compression fractures is that many people don’t even know that they have osteoporosis until a fracture occurs. So it is important to understand the risk factors. Women at greatest risk for osteoporosis are:
- white and Asian women over age 50
- women who are thin
- women who experienced menopause before age 50
- women who smoke
But it is important to remember that osteoporosis doesn’t affect only women. It may be true that osteoporosis is more common in women, but older men can suffer from this disease as well— especially if they have taken steroids, such as prednisone, for a long time. In fact, compression fractures have become a major health concern for older men.
Some types of cancer—such as multiple myeloma and lymphoma—can also cause compression fractures. In some people, a spinal fracture provides the first clue that they have cancer that has spread to their bones. Compression fractures can also be caused by an injury, such as a fall or auto accident.
How is a Compression Fracture Treated?
Most compression fractures are treated with conservative measures that include rest, medication for pain, and physical therapy, and they heal on their own. The initial pain usually subsides in a few days, but it can take up to three months for the fracture to heal completely. Severe fractures may take longer and require more medical intervention or, in some cases, surgery.
In most instances, over-the-counter painkillers, such as ibuprofen or naproxen, and ice packs are enough to relieve the pain. After the first week, applying heat is more effective until the fracture heals. Some doctors advise bed rest as well, but only for a few days. Prolonged inactivity can lead to other problems. When over-the-counter medications are not enough, the doctor may prescribe a narcotic pain medication for a short period of time or a muscle relaxant. Sometimes a back brace can help. Stretching exercises also can help by strengthening back muscles that support the spine, provided the doctor approves.
When these measures aren’t enough, surgery is an option. Surgical techniques that repair compression fractures include vertebroplasty and kyphoplasty. Both are minimally invasive procedures that use a cement-like material to repair the fractured vertebrae. Most patients go home the same day.
For other patients, spinal fusion may be an option. Fusing the fractured vertebrae stabilizes them and relieves the pain. Metal screws attach the vertebrae to a plate or rod that is bolted in place until the vertebrae heal.
How to Prevent a Compression Fracture
When osteoporosis is the culprit, treatment also needs to focus on strengthening the bones in the spine to prevent future fractures. Taking calcium supplements and Vitamin D, kicking the smoking habit, and doing weight-bearing and strengthening exercises are all things that can make a difference.
Several bone-strengthening drugs are available to restore bone loss. These drugs belong to a class of drugs called bisphosphonates. However, bisphosphonates can cause bone loss in the jaw, so discuss the risks with your doctor. Teriparatide is an injectable synthetic hormone that stimulates bone growth in women with severe osteoporosis. Evista and Reclast, which are both estrogen-like medications, also may offer help with bone density problems.
If you are taking a steroid medication for another medical condition, talk to your doctor to see if you can safely reduce the dose. Long-term use of steroids increases the likelihood of developing osteoporosis.
Contact Inspired Spine
Only a skilled spine specialist can determine whether you have a compression fracture or may be at risk for one. Contact the spine specialists at Inspired Spine to know for sure and learn the steps you can take to prevent future problems.