Compression Fracture Causes, Symptoms, and Treatments

Compression fractures often develop due to osteoporosis, when the bones become more brittle and likely to break. Injuries to the spine or back can also cause a compression fracture. Tumors, usually those that began elsewhere in the body and spread to the bone, can also contribute.

At first, compression fractures may be completely asymptomatic. As they progress, the injured person typically experiences slowly worsening back pain that may be alleviated by lying down. Loss of function or range of motion is common. Many people with compression fractures adopt a unique stooped posture — kyphosis. If there is nerve damage, sensations such as numbness or tingling can occur, alongside a loss of bowel or bladder control and trouble walking.

Osteoporosis is the [citation href="https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968" title=Mayo Clinic" desc="Osteoporosis"]most significant risk factor for developing a compression fracture. Because of this, females are more likely to get them, especially after menopause. People with a family history of osteoporosis are also at risk. Individuals with smaller body frames and bone size are more prone to developing both conditions.  Smoking, excessive alcohol, and taking certain medications — particularly corticosteroids — reduces bone density and increases the risk of compression fractures.

To diagnose a compression fracture, a healthcare provider will discuss family history and recent injuries before performing a physical exam. Clear signs include pain or a hunched upper spine. Imaging tests such as X-rays, computed tomography (CT), or magnetic resonance imaging (MRI) scans can provide a clear visual of the spine. Bone density scans can detect osteoporosis and its effects.

Because back issues are so common, it can be difficult to know when to visit a doctor. A person with osteoporosis, cancer, or a previous injury should seek medical attention if they develop back pain. Worsening symptoms also typically indicate a need for immediate treatment. Loss of bladder or bowel control is a sign of nerve damage, which is a serious medical issue.

Compression fracture treatments can vary depending on the source and severity of the damage. Pain-relieving medications and bed rest are the most common treatments for minor issues. Some people wear a back brace or similar compression equipment. A doctor may recommend physical therapy to improve flexibility and range of motion. If bone weakening is occurring, treatment will focus on osteoporosis.

In more severe cases, surgical procedures may be necessary. Vertebroplasty involves injecting quick-setting bone cement into the fractured vertebra. This provides support for the area while also leading to pain relief. Kyphoplasty is a similar procedure, but a surgeon will use balloons to expand the vertebral space before adding the cement.

Compression fractures can have several complications. Sometimes the bones do not heal after treatment and damage other vertebrae. Kyphosis can eventually lead to severe pain and problems with the chest organs, including the heart and lungs. Chronic pain, nerve problems, and blood clots may also occur, all of which can dramatically limit mobility.

To prevent a compression fracture, avoid activities that may damage the spine. This includes contact sports and repetitive heavy lifting. Back and abdominal exercises alongside a calcium-rich diet can strengthen the areas most likely to develop compression fractures. Speak with a medical professional about a bone density test to determine the likelihood of osteoporosis. Do not smoke and limit alcohol consumption to reduce the risk of osteoporosis and cancer.

Osteoporosis-related compression fractures often improve with medications and bed rest. Most cases heal within a few months, though some may cause long-term issues. Compression fractures from injuries recover in about eight weeks but may take longer if surgery is necessary. If cancer or a tumor is the cause, the recovery time is highly variable.