Normal Back Pain Or Compression Fracture? 6 Signs You Can't Overlook

Are you experiencing back pain that won't go away? While back pain is a common issue that will impact 80% of people at some point in their lives, it can also be a sign of something more serious. Vertebral compression fractures are an often-overlooked cause of back pain and when left untreated, can lead to further health issues.

What is a vertebral compression fracture?

Vertebral compression fractures are small fissures or breaks that appear in the bones in your spine (image below).

Image: The red arrow indicates a broken and compressed vertebral body (vertebral compression fracture). For comparison, look at the three vertebra above the compression fracture which are not fracture and of normal height.

Fractures can cause the vertebra to compress, which can eventually impact your height, your posture, and even lead to serious medical conditions such as blood clots and pneumonia. While the potential for experiencing a compression fracture increases with age, age is not the sole contributing factor. Vertebral compression fractures impact a startling 750,000 people annually. The most common indicator includes lower back pain in varying degrees of intensity. Back pain can occur suddenly, as the bone begins to compress, or it can build gradually over time.

What causes a vertebral compression fracture?

A vertebral compression fracture can happen to anyone; however, the leading cause of a compression fracture is Osteoporosis or other diseases that lead to low or poor bone density.

Image: The vertebra on the left of the screen has normal bone density. You can see how there are far fewer empty spaces within the bone when compared to the vertebra on the right of the screen. Low bone mineral density is one of the primary risk factors for a compression fracture.

In a healthy individual, trauma such as a car accident or sporting accident can cause a compression fracture and severe back pain. Individuals who already have low bone mineral density are at a much higher risk of compression fracture. As your bones become weakened or porous, even minor events such as stumbling, sneezing, or stepping out of the shower can cause a vertebral compression fracture.

What are common signs of a compression fracture?

Lower back pain is the primary indicator that you may be experiencing a compression fracture. But how do you determine if your back pain is caused by more than a general strain? These common signs may indicate you are dealing with a compression fracture.

• The onset of pain happens suddenly and rapidly.
• Pain decreases while lying down but increases while standing or sitting.
• Your ability to turn or bend decreases significantly.
• Pain increases when pressure is applied to the painful area.
• Pain worsens with movement.
• You experienced a recent trauma or injury, including minor events.

Why is early diagnosis and treatment important?

When left untreated, a vertebral compression fracture can lead to a multitude of back issues, as well as health risks and even death. While some health problems such as kyphosis, an unnatural curvature of the spine, result directly from a compression fracture, other health risks are a byproduct of pain and immobility.

Image: Compression fractures can cause a "hunchback" appearance which is due to a permanent bend in the spine called kyphosis. Kyphosis can lead to pain, poor inspiration, and loss of height.

Severe pain leads to inactivity, putting you at risk for blood clots, muscle wasting, and pulmonary issues. Long term use of painkillers can cause further loss of bone density and recurring compression fractures. Recent studies indicate that identifying and treating compression fractures early reduces the risk of fracture-related death and disease.

What are the treatment options for a compression fracture?

The first step to getting treatment for a compression fracture is determining the level of pain and damage in your spine. Conservative treatments include using a back brace, taking pain medication (both over the counter or prescription), and receiving physical therapy. When pain is severe, ongoing, or inhibiting, a common treatment is a vertebral augmentation. Two forms of minimally invasive augmentation are used today: kyphoplasty and vertebroplasty. While both treatments use bone cement to stabilize the damaged vertebra, kyphoplasty uses a unique method to first boost the compressed vertebra before inserting the cement. This practice helps re-establish the height and shape of the vertebra, decreasing both pain and spinal curvature.

Image: The image on the right shows how the height of the shattered vertebral body (on the left) has been restored with kyphoplasty. The white material in the vertebral body on the right is bone cement, which adds significant stability to the injured vertebral body as it heals. Most patients who undergo kyphoplasty for a compression fracture experience pain relief less than one hour after the procedure is finished.

Should I seek medical help for my back pain?

You should seek help if you have been experiencing back pain for more than four weeks or were recently in an accident or traumatic event that induced back pain. Even if you do not have Osteoporosis, low bone density, or remember experiencing trauma or an accident, ongoing back pain could be a sign of a bigger issue and it is important to get a proper diagnosis and care. If you have previously had a vertebral compression fracture, and your back pain has either returned or has been ongoing, consider seeking immediate medical attention.

A strong and healthy spine is an important ingredient to living an active, unhindered lifestyle. Pain and immobility are both a nuisance and a potential cause of unexpected health risks, all of which can be avoided with the right care and treatment. If your back pain is getting you down, and keeping you down, it may be time to seek medical care.

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