A compression fracture of the spine is a break in one or more of the bones in the back, called vertebrae. This condition is common, especially in older adults, and can cause sudden or gradual back pain, loss of height, and changes in posture. Most compression fractures heal with proper treatment, and many people can return to their usual activities. Early diagnosis and care can help prevent further problems and improve quality of life.

A compression fracture of the spine happens when a bone in the back, called a vertebra, collapses or breaks under pressure. The vertebrae are the small bones stacked on top of each other that form the spinal column, which supports the body and protects the spinal cord (a bundle of nerves running through the back).

In a compression fracture, the front part of the vertebra is usually squashed into a wedge shape, while the back part stays more intact. This type of fracture most often affects the middle or lower part of the spine, especially the area where the upper and lower back meet (known as the thoracolumbar junction).

Compression fractures are most common in older adults, especially those with osteoporosis, a condition in which bones become weak and brittle. Sometimes, people with a compression fracture do not notice any symptoms, and the fracture is found by chance on an X-ray or other imaging test. In other cases, the fracture causes sudden or severe back pain, loss of height, or a rounded back.

The main cause of compression fracture of the spine is osteoporosis. In people with osteoporosis, even simple actions such as bending, lifting, or sneezing can cause a vertebra to break, and it can happen with little or no obvious injury. As people age, bones naturally lose minerals like calcium, which increases the risk of fractures.

Other causes of compression fractures include:

• Trauma, such as a fall, car accident, or sports injury, which can break a healthy vertebra. In younger people, compression fractures usually result from a strong force or injury.
• Cancer that spreads to the spine (metastatic tumors), which weakens the bone and makes it more likely to collapse.
• Tumors that start in the spine, such as multiple myeloma, a cancer of plasma cells within the bone marrow.
• Rarely, certain infections or conditions that affect bone strength.

Risk factors for compression fracture of the spine include both things people cannot change and things they can. The main risk factors are:

• Older age: bones lose strength as people get older
• Osteoporosis: a condition that makes bones weak and more likely to break
• Being female: women, especially after menopause, have a higher risk due to lower bone density
• Having had a previous compression fracture: one fracture increases the chance of another
• Low body weight: less body mass means less bone strength
• Use of certain medicines: long-term use of steroids or anticonvulsants can weaken bones
• Lack of physical activity: not moving enough can lead to weaker bones
• Smoking: tobacco use lowers bone strength
• Drinking too much alcohol: heavy alcohol use can weaken bones
• Low calcium or vitamin D: these nutrients are important for bone health
• Certain medical conditions: diseases such as rheumatoid arthritis, diabetes, thyroid problems, or long-term immobility can increase risk
• Family history: having close relatives with osteoporosis or a history of fractures
• Cancer: having cancer, especially a cancer that can spread to the bones, such as breast cancer, lung cancer, or prostate cancer

Symptoms of compression fracture of the spine can range from no symptoms at all to severe pain and disability. The most common symptoms include:

• Sudden back pain, often sharp or “knife-like,” usually in the middle or lower back
• Pain that gets worse with standing, walking, or movement, and feels better when lying down
• Gradual back pain that starts slowly and gets worse over time
• Tenderness over the affected area of the spine
• Loss of height (people may become shorter, sometimes by several inches)
• Stooped or hunched posture, or a rounded back (known as kyphosis or “dowager’s hump”)
• Limited ability to bend, lift, or move the back
• Muscle spasms in the back
• Difficulty walking or moving around

In rare cases, if the fracture presses on the spinal cord or nerves, symptoms may include:

• Numbness, tingling, or weakness in the legs
• Trouble walking or balancing
• Loss of control of the bladder or bowels

People should contact a doctor promptly if they have sudden back pain after a fall or injury, if their pain is severe or getting worse, or if they notice numbness, weakness, or problems with bladder or bowel control.

Diagnosis of compression fracture of the spine starts with a review of symptoms and a physical exam.

The doctor will ask about back pain, recent injuries, and any history of osteoporosis or cancer. During the exam, the doctor may check for tenderness along the spine, changes in posture, and loss of height. They may also look for signs of nerve problems, such as weakness, numbness, or trouble walking.

To confirm the diagnosis and find the cause, the following tests may be used:

• X-rays, to show if a vertebra is compressed or has lost height
• Computed tomography (CT) scan, to provide detailed images of the bones to check the shape and size of the fracture
• Magnetic resonance imaging (MRI), to show soft tissues, nerves, and whether the fracture is new or old; it can also help doctors find tumors or nerve problems
• Bone density test (DEXA scan), to measure bone strength and check for osteoporosis
• Blood tests, which may be done if cancer or infection is suspected, to look for abnormal proteins or other markers
• Additional imaging, such as bone scans, if the doctor suspects cancer or multiple fractures

Doctors may use special scoring systems to classify the fracture and guide treatment, especially if there are concerns about instability or nerve damage.

Treatment for compression fracture of the spine depends on the cause, severity, and symptoms. Most people can be treated without surgery, but some may need procedures if pain is severe or there are nerve problems. The main treatments include:

• Pain medicines, such as acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), or short-term opioids for severe pain
• Muscle relaxants may help with muscle spasms
• Bed rest for short periods may help, but early movement is encouraged to prevent muscle loss
• Back braces may be used to support the spine and reduce pain, but long-term use is avoided to prevent muscle weakness
• Physical therapy to strengthen muscles and improve posture and flexibility
• Medicines for osteoporosis, such as bisphosphonates, calcitonin, or other bone-strengthening drugs, may help prevent future fractures
• Calcium and vitamin D supplements to help maintain bone health

If pain does not improve with these treatments, if there is significant deformity, or if there are nerve problems, certain procedures may be considered, including:

• Vertebroplasty, in which a doctor injects bone cement into the broken vertebra to stabilize it and relieve pain
• Kyphoplasty, in which a balloon is used to create space in the vertebra before injecting a special kind of cement, which may help restore height and reduce deformity
• More extensive surgery, which is rarely needed, may be used to stabilize the spine or relieve pressure on nerves, especially if the fracture is unstable or caused by a tumor

Doctors will choose the best treatment based on the person’s age, health, fracture type, and symptoms. Most people do not need surgery.

Complications of compression fracture of the spine can affect movement, posture, and overall health. Possible complications include:

• Chronic back pain, which is pain that lasts for months or longer
• Kyphosis, which is a rounded, hunched back that can worsen over time
• Loss of height due to collapse of the vertebrae
• Reduced mobility, including trouble walking, bending, or doing daily activities
• Increased risk of more fractures, especially if osteoporosis is not treated
• Breathing problems, because severe kyphosis can make it harder to breathe deeply
• Digestive issues, because changes in posture can affect appetite and digestion
• Pressure sores, which can occur due to reduced movement and increased time spent in bed
• Blood clots, because prolonged immobility can increase the risk of deep vein thrombosis
• Nerve or spinal cord injury, which may occur if the fracture presses on nerves, leading to numbness, weakness, or loss of bladder or bowel control
• Complications from surgery or procedures, such as infection, cement leakage, or nerve injury

The outlook for people with compression fracture of the spine depends on the cause, the person’s age and overall health, and how quickly treatment begins. Most fractures caused by injury heal within eight to 12 weeks with rest, pain control, and physical therapy. People with osteoporosis-related fractures often feel better with medicines and activity. They may be able to return to some of their usual activities, but the compression fracture may cause them to lose height, develop a rounded back, and/or have ongoing pain or disability.

Treating osteoporosis and following a bone health plan can help prevent future fractures.

If the fracture is due to cancer, the outlook depends on the type and stage of the cancer and whether it has spread from elsewhere in the body. Early diagnosis and proper treatment of cancer that affects bone can improve the chances of recovery and help maintain independence and quality of life.

This article was medically reviewed in June 2026.