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Vertebral Compression Fracture

A vertebral compression fracture occurs when a spinal vertebra collapses, often due to osteoporosis. It is common among the elderly and causes back pain.

Causes of Vertebral Compression Fractures

A vertebral compression fracture occurs when the load on the spine becomes greater than what the vertebra can withstand:

  • Osteoporosis: The most common cause by far. With osteoporosis, the skeleton becomes porous and weak, which means a vertebra can collapse during everyday activities.
  • Trauma: Falls or hard impacts to the back can cause fractures even in individuals with normal bone density.
  • Tumor diseases: In rare cases, the spread of disease to the skeleton can weaken the vertebra so that a compression occurs.
  • Long-term cortisone treatment: A known side effect of long-term cortisone use is that the skeleton weakens and becomes less dense.

    • Symptoms of Vertebral Compression Fracture

    Symptoms can vary greatly; some barely notice it, while others experience intense pain:

  • Sudden and severe back pain: Often, a sharp pain occurs in the thoracic or lumbar spine in connection with lifting, sneezing, or a minor stumble.
  • Reduced body height: When one or more vertebrae collapse, you become measurably shorter.
  • Changed posture: A noticeable forward lean or an increased curvature in the upper part of the back.
  • Pain during movement: The ache often worsens when walking or standing, but can be relieved when lying down on your back.

    • Diagnosis of Vertebral Compression Fracture

    To confirm a vertebral compression fracture and assess its extent, the following methods are used:

    • X-ray: The primary method to see if a vertebra has decreased in height or changed shape.
    • MRI or CT: Used in more complicated cases to see if nerve tissue is affected or to determine how recent the fracture is.
    • Bone density measurement (DEXA): Often performed after a confirmed vertebral compression fracture to investigate if underlying osteoporosis is present.

      • Blood Tests in the Investigation of Vertebral Compression Fracture

      When a vertebral compression fracture caused by osteoporosis is suspected, blood tests are often taken to rule out other medical causes and check the mineral balance. Common tests include Calcium and Albumin to see the status of the skeleton, as well as Vitamin D since a deficiency can weaken the skeleton. ALP (alkaline phosphatase) is also often measured, as it can rise during bone turnover. Tests for kidney function and metabolism are often taken to get a comprehensive view of the factors affecting bone health.

      Treatment of Vertebral Compression Fracture

      The goal of treatment is to relieve pain and prevent more vertebrae from being affected:

      • Pain relief: Medication is used in the acute stage to enable movement.
      • Physiotherapy: Adapted exercise to strengthen the back muscles and improve balance.
      • Osteoporosis medication: If osteoporosis is confirmed, treatment is often initiated to strengthen the skeleton and reduce the risk of future fractures.
      • Back brace: In some cases, a back support can be used for a short period for stability and relief.

        • Preventive Measures to Minimize Risk

        You can influence the strength of your skeleton yourself through active choices:

      • Physical activity: Weight-bearing exercise such as walking, dancing, or strength training stimulates the skeleton to become stronger.
      • Diet and nutrition: Ensure an adequate intake of calcium and vitamin D through your diet, for example via dairy products, fish, and eggs.
      • Fall prevention: Review your home to reduce the risk of falls, for example by removing loose rugs and having good lighting.

    Questions and answers

    The most frequent cause is osteoporosis, which makes the bones porous and weak, allowing a vertebra to collapse even during everyday activities. Other causes include physical trauma (falls) or, more rarely, tumors.

    Key symptoms include sudden, sharp back pain (often triggered by lifting or sneezing), a measurable loss of height, and a change in posture, such as an increased forward curve of the upper back.

    Tests are conducted to check mineral balance and bone turnover. Common markers include Calcium, Albumin, Vitamin D, and ALP (Alkaline Phosphatase). Kidney function and metabolism are also checked to assess overall bone health.

    Other symptoms

    Shoulder Impingement

    Subacromial Impingement Syndrome – when compressed tissues lead to shoulder pain and reduced mobility

    Carpal Tunnel Syndrome

    Median nerve compression – a condition where pressure builds up in the narrow passage of the wrist, affecting nerve function and hand strength

    Sacroiliitis

    SI joint inflammation – the clinical term for inflammation in the sacroiliac joints.

    Spondylarthrosis

    Osteoarthritis of the joints of the spine which can cause pain and stiffness

    Scoliosis

    Understanding scoliosis – also known as spinal curvature or lateral deviation of the spine

    Runner's Knee

    ITBS – Runner's knee refers to irritation of the tendon on the lateral side of the knee

    Cruciate Ligament Injury

    ACL or PCL tear – is a stretch or rupture of the stabilizing bands within the knee

    Meniscus Injury

    meniscus tear – involves damage to the knee's shock-absorbing cartilage, impacting both mobility and stability

    Bone Infection

    Osteomyelitis – occurs when microorganisms trigger inflammation that can damage bone tissue and restrict blood flow within the bone

    Rhabdomyolysis

    The acute destruction of striated muscle cells – It is sometimes colloquially associated with "exertional heatstroke" or "crush syndrome" depending on the cause

    Bilateral foraminal stenosis

    The narrowing of the spinal nerve outlets affecting both sides of a specific spinal level simultaneously

    Facet Joint Osteoarthritis

    facet syndrome or spinal arthritis – refers to the gradual wear and tear of the spine's small joints, leading to pain and restricted movement

    Herniated disc

    ruptured disc – occurs when the soft center of a spinal disc pushes through the casing, irritating nearby nerves

    Spinal stenosis

    Spinal narrowing – A narrowing of the spinal canal causing nerve compression

    Fibromyalgia

    "Chronic Widespread Pain (CWP) syndrome" – Heightened pain sensitivity

    Restless Legs Syndrome

    Willis-Ekbom Disease – is a condition causing uncomfortable sensations and an irresistible urge to move the legs, primarily during periods of inactivity

    Osteoporosis

    Brittle bone disease - a condition where bones become porous and fragile

    Muscle tear

    Pulled muscle – A muscle strain involves partial or complete damage to the muscle tissue

    Gout

    Heel spur

    Rheumatoid arthritis

    Artros

    Arthritis