What is a Compression Fracture and How do I fix it?
A compression fracture is a type of bone fracture that occurs when a vertebra in the spine collapses due to excessive pressure. This often happens in the thoracic (mid-back) or lumbar (lower back) spine and is commonly caused by osteoporosis, trauma (such as a fall or car accident), or tumors that weaken the bone.
Symptoms of a Compression Fracture:
Sudden or gradual back pain
Height loss over time
Limited spinal movement
Kyphosis (hunched posture) in severe cases
Possible nerve-related symptoms if the fracture compresses spinal nerves
Treatment Options:
1. Conservative (Non-Surgical) Treatments:
Pain Management: Over-the-counter pain relievers (acetaminophen, NSAIDs) or prescription medications.
Bracing: A back brace can provide support and stability.
Rest & Activity Modification: Avoiding heavy lifting and high-impact activities while staying moderately active.
Physical Therapy: Strengthening exercises to support the spine and improve mobility.
Osteoporosis Management: Medications (such as bisphosphonates) to strengthen bones and prevent future fractures.
2. Minimally Invasive Procedures (for persistent pain or severe cases):
Vertebroplasty: A medical-grade bone cement is injected into the fractured vertebra to stabilize it and relieve pain.
Kyphoplasty: A small balloon is first inserted into the vertebra to restore height before injecting cement.
3. Surgical Intervention (Rare but Necessary in Severe Cases):
Spinal Fusion or Instrumentation: If the fracture causes spinal instability or nerve compression, metal rods, screws, or bone grafts may be used to stabilize the spine.
Recovery:
Most mild to moderate compression fractures heal within 8 to 12 weeks with conservative treatment. Severe fractures or those requiring surgery may take longer. Preventing future fractures by addressing osteoporosis, maintaining good posture, and strengthening the back muscles is crucial.
Treatment Options for a Compression Fracture
The best treatment depends on the severity of the fracture, underlying causes (such as osteoporosis or trauma), and symptoms. Treatment generally falls into three categories: conservative (non-surgical), minimally invasive, and surgical.
1. Conservative (Non-Surgical) Treatment
For mild to moderate fractures that do not cause spinal instability or nerve compression.
Pain Management
Over-the-counter medications (acetaminophen, ibuprofen, or naproxen)
Prescription pain relievers (muscle relaxants, opioids for severe pain)
Nerve pain medications (if nerve involvement)
Activity Modification & Rest
Limit bending, lifting, and twisting to prevent worsening the fracture.
Short-term bed rest may be recommended, but prolonged immobility can lead to muscle loss and worsen osteoporosis.
Bracing
A back brace (TLSO brace) can help stabilize the spine, reduce pain, and support healing.
Usually worn for 6-12 weeks, depending on the severity.
Physical Therapy
Once pain improves, core-strengthening and posture exercises help prevent future fractures.
Weight-bearing exercises are crucial for osteoporosis patients to strengthen bones.
Osteoporosis Treatment (If osteoporosis is the cause)
Calcium & Vitamin D supplements
Bone-strengthening medications (bisphosphonates, denosumab, or newer options like romosozumab)
Lifestyle changes (quit smoking, reduce alcohol, and engage in resistance training)
2. Minimally Invasive Procedures
If pain persists after 6-8 weeks of conservative treatment, or if the fracture causes spinal instability.
Vertebroplasty
A needle injects medical-grade bone cement into the fractured vertebra.
The cement hardens quickly, stabilizing the bone and reducing pain.
Best for recent fractures (within a few months).
Similar to vertebroplasty but includes a balloon to restore lost vertebral height before injecting cement.
Helps correct spinal curvature (kyphosis) caused by compression fractures.
Recovery:
Outpatient procedure with same-day discharge.
Most patients feel pain relief within 24-48 hours.
3. Surgical Treatment (Rare but Necessary in Severe Cases)
For fractures that cause severe instability, spinal cord compression, or significant deformity.
Spinal Fusion & Instrumentation
Involves using metal rods, screws, and bone grafts to stabilize the spine.
Reserved for severe fractures or those caused by trauma/tumors.
Recovery:
Requires a hospital stay and a longer recovery period.
Physical therapy is crucial for regaining strength and mobility.
Which Treatment is Best?
Mild to moderate fractures: Conservative treatment.
Severe pain lasting >6 weeks: Vertebroplasty or kyphoplasty.
Spinal instability, nerve compression, or deformity: Surgery.
