Compression fracture treatments can be surgical or nonsurgical, depending on the severity of the injury.

A compression fracture typically occurs in the vertebrae (bones of the spine) and can reduce the height of the affected bone or bones. Currently, available surgeries reform the bone by filling it with a special type of cement.

People with less severe compression fractures may recover without surgical intervention. To prevent future fractures in people with osteoporosis, doctors may prescribe bisphosphonates.

This article looks at types of compression fractures, treatments, recovery, prevention, and more.

An X-ray of the spine.Share on Pinterest
Science Photo Library – MIRIAM MASLO./Getty Images

A compression fracture is a bone break to the spine’s vertebrae.

Osteoporosis is the most common cause of compression fractures. The condition weakens a person’s bones to the extent that they break more easily.

In most cases, the front of the affected vertebra fractures and gets shorter, and the back of the vertebra stays as is. The bones do not usually move out of place in compression fractures and do not usually cause problems with the nerves and spinal cord.

In rare cases, osteoporosis compression fractures involve the vertebra’s middle or back part. This can cause instability and requires surgical repair.

Estimates suggest that compression fractures happen 1.5 million times yearly in the United States. Compression fractures of the spine are twice as common as broken hips and wrists among people with osteoporosis.

Osteogenesis imperfecta is another medical condition that causes the bones to weaken and may make a person more susceptible to compression fractures.

Other causes of compression fractures include severe trauma, including road accidents, sports injuries, and hard falls. Compression fractures can also arise due to tumors that started somewhere else in the body and traveled to the spine.

Symptoms of a compression fracture include back pain, usually at the site of the fracture. This usually worsens when a person changes positions, coughs, or sneezes, and it often improves with rest.

Compression fractures commonly occur in the lumbar or thoracic spine. This is the area around the waistline, mid-chest, and lower back.

Imaging tests, including X-rays, MRI scans, and bone scans, can help doctors determine whether the fracture is acute (new) or chronic (old).

A 2016 article in American Family Physician notes that over two-thirds of people with compression fractures do not have symptoms. They may only find out that they have a compression fracture when they undergo imaging tests for another health issue.

Treatment may be nonsurgical or surgical, depending on the severity of the injury.

Nonsurgical treatment

Some people can recover from a compression fracture with rest and limited use of pain relief medications. In some cases, doctors may recommend a brace. A brace works by restricting a person’s movement so that the broken vertebra can heal on its own.

Other nonsurgical methods for treating compression fractures include:

Surgical treatment

Doctors reserve surgery for people with severe pain that does not go away with nonsurgical treatment. Depending on the nature of the fracture, a doctor may recommend kyphoplasty or vertebroplasty.

During a kyphoplasty operation, the surgeon uses an X-ray as a guide while inserting a hollow needle into the fractured bone. They then insert a device called a balloon tamp into the needle. The surgeon inflates the tiny balloon inside the broken vertebra to restore its height and shape. They then fill the space with a special type of cement that reinforces the vertebra.

Vertebroplasty is similar to kyphoplasty, except the surgeon injects the cement directly into the compressed vertebra instead of first using a balloon tamp.

A person’s doctor will give them an idea of a realistic timeframe for recovery. Most people with compression fractures get better within 3 months with rest and pain relief.

If a person has kyphoplasty or vertebroplasty, they can return to their usual daily activities as soon as possible following the surgery.

Once a compression fracture heals, it will not collapse any further. However, the healed vertebra does not return to its exact original shape.

A person with a compression fracture needs immediate treatment for the pain and risks associated with having a broken vertebra. Prevention of future fractures is also essential.

If a person’s compression fracture is due to osteoporosis, a doctor may suggest treatments for bone density loss. Doctors can prescribe bisphosphonates, such as Actonel, Boniva, or Fosamax, to strengthen the bones by stabilizing bone loss or restoring lost bone.

A 2017 meta-analysis concludes that taking bisphosphonates effectively reduces the risk of fracture associated with osteoporosis.

A person should seek immediate medical attention if they have back pain in addition to the following:

  • losing control of their bowels and bladder
  • severe pain, numbness, or weakness
  • high fever

It is also important for a person to talk with a doctor about their back pain if:

  • they are over 65 years old or under 12 years old
  • their pain is the same at rest as during activity
  • they have unintentionally lost weight
  • they have or have had cancer

Most people with compression fractures get better without needing medical intervention other than pain relief.

However, older people who experience compression fractures associated with osteoporosis have a higher risk of dying than their peers without osteoporosis. Survival rates are:

  • 53.9% at 3 years
  • 30.9% at 5 years
  • 10.5% at 7 years

Regarding surgery outcomes, one review from 2020 suggests that kyphoplasty and vertebroplasty provide significant pain reduction compared to nonsurgical treatment. Additionally, kyphoplasty tends to result in better restoration of bone height than vertebroplasty.

Compression fractures are most commonly related to weakened bones due to osteoporosis.

Other causes include trauma, osteogenesis imperfecta, and tumors spread to the spine from elsewhere in the body. Most people get better with rest and pain relief, but some may require surgery.

Doctors can prescribe bisphosphonates to strengthen the bones of people with osteoporosis and help prevent future compression fractures.