Causes of Back Pain: Compression Fractures

A compression fracture is a collapse of one of the vertebral bones, which may cause back pain, neck pain, and a stooped posture.

A compression fracture is a collapse of one of the vertebral bones. Compression fractures of the vertebra may be due to a trauma or accident, but is more likely the result of a condition that causes the bone to weaken. Though the vertebral bones take one a lot of added pressures when we sit, stand, and lift objects in the erect position, they are built very strong, and will resist becoming injured as long as the bones are healthy. The bones may become unhealthy due to hormonal disorders and other conditions that affect bone density, and other diseases that make the bone more vulnerable to fracture. The compression fractures usually occur in the body of the vertebra, which is the part of the bone designed to bear the weight of the bone and the weight of the spine. Typically, compression fractures do not heal on their own, and the vertebral bones will not return back to their previous shape without medical intervention. The best treatments for this condition will always be prevention, and steps to improve the bone density and strength of the bone. When compression fractures do occur, there are two treatments (kyphoplasty and vertebroplasty) that are designed to pump back up the vertebral body and then fill in the cracks, similar to getting a tooth filling at the dentist. We will further discuss the available treatments below.

Causes of back pain: Compression Fractures

When one thinks of fractures of the bones, one thinks of a single event where the bone cracks in half as a result of one traumatic evens. With compression fractures, this is not usually the case. With compression fractures, the weight bearing bones begin to buckle or collapse in on themselves due to a combination of whatever is weakening the bones and constant weight being put on these weight bearing bones. Compression fractures are caused by congenital weakness of the bones, age related changes in bone density that make them vulnerable to fractures, disease, and trauma. Older males and females are more prone to weakening of the bones, due to the decrease on bone density that occurs in our bones as we get older. Women, who are more prone to osteoporosis, are more likely to develop compression fractures as they reach and pass the age of menopause. Treatments for osteoporosis related compression fractures include hormone replacement therapy, calcium supplementation, Vitamin D supplementation, and calcitonin. All of these osteoporosis related treatments have been shown to increase bone density.

Other Causes - Congenital abnormalities such as osteogenesis imperfect make the bones of the body, especially the weight-bearing bones, more vulnerable to breaks or buckling of the bones. Other causes of compression fractures include infection and lytic lesions from primary or metastatic tumors. Vertebral bones in healthy individuals are very strong, and resistant to breaking along the vertebral bodies, which can absorb tremendous pressure. In the event of an accident, it is much more likely that the soft tissues of the spine will be effected. Still, high velocity accidents such as car crashes may be sufficient enough to cause the vertebra to buckle.

Diagnosis: To test for compression fractures, patients will typically have frontal and lateral X-Rays of their spine. The lateral views will be especially revealing to show if the vertebral bodies are buckling in on themselves. In a normal lateral view X-Ray, the vertebral bodies are block shaped. With compression fractures, you may see what is known as wedge deformities, where the vertebral body is thicker posteriorly than anteriorly. This change in shape may pull the spine out of its position, causing back pain and accelerated degenerative changes to the structures around it.