Spine Fractures

What is a spine (vertebral) fracture?

A broken bone in your spine is called a vertebral fracture. Vertebral fractures occur in the part of the bone called the vertebral body. The vertebral body supports your weight. When an individual has osteoporosis, the vertebral body becomes weak and susceptible to a fracture or break. It is the most common fracture or break that occurs as a result of osteoporosis. In the United States alone, there are approximately 700,000 vertebral fractures diagnosed each year.

What happens when a vertebral fracture occurs?

When a vertebral fracture occurs, the bone becomes compressed, shatters, and falls in on itself. This type of fracture or broken bone is different than a fracture of a bone in the arm or leg. When a bone in the spine breaks, the bone does not break in two but instead it collapses. This may be diagnosed as a collapsed vertebrae or compression fracture.

Are there different types of vertebral fractures?

 There are different types of vertebral fractures that can cause the shape of the vertebrae to change. Your medical professional will determine what type of fracture you have by the appearance of the collapsed vertebrae. The three types of vertebral fractures are known as:

• Concave deformity
• Wedge fracture
• Compression fracture

How does a vertebral fracture happen?

When someone has osteoporosis they have an increased risk for fracture. A vertebral fracture can occur spontaneously in an individual with osteoporosis. There may be no precipitating event or trauma. It may result from routine movement such as bending over to pick up an object, even as light as a newspaper off the floor. Some individuals have experienced fractures when performing daily housework such as making the bed or vacuuming the floor. People with osteoporosis may develop compression fractures as a result of severe coughing or sneezing. Even an affectionate hug from a loved one has been reported to cause a spine fracture in individuals with advanced osteoporosis.

Do vertebral fractures cause pain?

Some people will not have any symptoms or pain as a result of a vertebral fracture. Other individuals experience excruciating pain. It still is not clear why some people have pain and others do not. A fracture of one or more vertebrae can cause a sharp, stabbing pain and/or persistent back pain or discomfort. Sometimes a vertebral fracture can even irritate the surrounding nerve roots and produce pain that radiates around the side of the abdomen or chest. Depending upon the location and severity of the spine fracture, individuals may experience difficulty breathing, stomach pain, or digestive discomfort.

People who have multiple vertebral fractures may experience chronic back pain. The abnormal stretching of muscles, ligaments, and tendons as a result of the change in the shape of the chest and back may cause this discomfort. Following strategies for safe movement along with taking short rest periods may ease your discomfort and allow you to perform your usual daily activities.

How can vertebral fractures change my appearance?

Vertebral fractures may affect other parts of your body besides the broken bones. Multiple fractures of the spine can change your appearance by causing loss of height, a curving of the shoulders and back, and a thickening waistline. You may notice that your clothing does not fit the same way. Your shirts and jackets may pull across your back. The hemlines of your skirts and pants may not hang properly. It is often difficult to find comfortable, stylish clothes. The good news is that with growing awareness about osteoporosis, fashion designers are taking a special interest in the design and marketing of apparel especially for individuals with postural changes (See:  National Osteoporosis Foundation).

Does a vertebral fracture increase my risk for other fractures?

• If you have a vertebral fracture, it is important that it is diagnosed and treated quickly.  A vertebral fracture greatly increases your risk for more spine as well as other fractures. In fact, in the year following a vertebral fracture, almost 1 out of 5 women will experience another spine fracture. A woman with a history of fractures has almost 1.5 to 2 times the risk of hip and other fractures than a woman without any history of fractures. If you have a fracture in adulthood that occurs with minimal trauma, most commonly occurring after a fall from standing height, it should be taken seriously as a warning that you may have osteoporosis and be at risk for future fractures.
• If you have had a vertebral fracture and have not yet had a BMD (bone mineral density) test, speak to your medical professional about having this simple, noninvasive test. A BMD test can diagnose low bone mass or osteoporosis. Low bone mass is the single most important risk factor for fracture. A BMD test can be used by your medical professional to help predict your chances for fracturing in the future and to help monitor your response to treatment.
• If you have osteoporosis and/or have already had a fracture, there are FDA-approved medications that can be prescribed by your medical professional to greatly reduce the risk for future fractures.

How do you treat vertebral fractures?

Everyone experiences pain differently and the recuperation period is unique for each individual. The recovery period may be different for you and therefore it is important for you to listen to your own body cues. When you experience pain and fatigue, you might need to rest more. While you are recuperating, you might need assistance with dressing, bathing, getting in or out of a chair and/or bed. 

Surgery is typically not required and the healing process includes rest, reducing activities, heating pads, ice packs, and pain medications when needed. Some medical professionals may suggest that you wear a spinal support device or brace. In more severe cases, there are special surgical procedures called vertebroplasty and kyphoplasty that may be considered. Your medical professional will know what is right for you.

Rest is important, but as soon as you can tolerate it, get moving! Activity helps maintain bone density and can increase muscle strength. Consult your medical professional about seeing a physiatrist, physical therapist, and/ or occupational therapist to assist you with the principles of safe movement.

How long is the recovery period? 

A fractured vertebra usually takes 4 to 6 weeks for the bone to set and may take up to 16 weeks to heal completely. Clearly, an individuals age and other existing medical conditions may influence the length of the recovery period following the fracture.

What can I do to promote healthy bones?

It is always important to follow the universal strategies for healthy bones. These strategies include:

• Getting adequate calcium and vitamin D each day
• Exercising to the extent of your limitations, on a regular basis, using principles of safe movement
• Avoiding smoking and the use of tobacco products
• Limiting alcohol consumption - Excessive consumption of alcohol is harmful to bones and increases the risk for fractures related to more frequent falls and accidents.
• Taking safety precautions to prevent falls is important for everyone but it is a special concern if you have an increased tendency to fall due to a medical condition or the need to take certain medications that cause lightheadedness or dizziness. Following safety strategies in your home and outdoors is imperative to prevent falls
• Reviewing the medications that you take with your medical professional will help you determine if any may contribute to bone loss. It is important to discuss options with your medical professional and make sure that you are on the lowest possible doses to control your medical condition. Always take the medication prescribed by your medical professional as directed.

Healthy bones are a lifelong commitment. It is never too early or too late to take the steps to prevent osteoporosis.  At any age you can reduce your risk for falling and breaking a bone.