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Compression Fractures, Strains, and Falls: How To Prevent Winter Back Injuries

BY CARRIE MACMILLAN February 13, 2023

A Yale Medicine orthopaedic spine surgeon discusses how to protect your back during winter months.

Winter weather can be treacherous for your back. Whether it's a lumbar strain from shoveling wet, heavy snow or taking a spill on a slick sidewalk, winter conditions can seriously affect your back health. 

The snow isn’t going to clear itself, but there are certain shoveling techniques you can use to avoid common back injuries. Likewise, not all falls can be avoided, but there are things you can do to improve your chances of staying upright on those icy walkways.

Below, Daniel Rubio, MD, a Yale Medicine orthopaedic spine surgeon, shares advice on how to keep your back healthy this winter.

1. Beware of ice: falls can lead to hip, wrist, or ankle fractures.

It may seem obvious, but the first rule is to simply be careful when there’s any ice on the ground, Dr. Rubio explains.

“If you can’t get someone to shovel or clear your driveway, make sure you put down salt for ice and wear boots that are made for walking on ice, such as ones with slip-resistant soles or metal spikes,” he says. “A common trauma accident we see is an elderly person who slips on the ice and then falls on their back or buttock; it might result in a hip, wrist, or ankle fracture—or even a spine injury.”

The spine injury might include fractures, which are breaks in the vertebrae (the bones of your spinal column)—the most common of which are called vertebral compression fractures.

“The good news is that, unlike with a hip fracture, which needs surgical intervention, a compression fracture can be treated nonsurgically,” Dr. Rubio says. “We first get an X-ray to confirm the diagnosis. Then, restrictions are usually discussed with the patient, such as not doing any repetitive bending or twisting, or lifting anything more than 20 pounds for three months. We also give them a brace to prevent the compression fracture from progressing and to improve function during the fracture healing.”

In rare cases in which pain continues longer than three months, you might need a procedure, such as a vertebroplasty, which requires a small incision, adds Dr. Rubio. “We would put a needle into the vertebral body and inject cement, which helps reduce the pain associated with particularly stubborn fractures,” says Dr. Rubio.

2. Take extra precautions if you are older or have osteoporosis.

A major risk factor for falls and fractures is osteoporosis, a condition in which bones become weak and brittle.

“If you are older than 65, and especially if you are a woman, your body undergoes changes that can result in osteoporosis,” Dr. Rubio says. “Plus, in older adults, the sense of balance is not as responsive as it is in younger people.”

A wide range of factors can affect balance, including medications, inner ear problems, or a prior stroke. In addition to balance issues, which can lead to falls, older people may be predisposed to fractures if their bone health is not optimal.

If balance is a concern, consider using a walker or a double cane for better stability, Dr. Rubio advises.

3. Shovel smartly to avoid lumbar strains.

Lumbar strains—the name for injuries to the lower back in which muscle fibers become abnormally stretched or torn—are a common condition Dr. Rubio sees.

“Many patients get lumbar strains from lifting heavy objects, including snow from shoveling,” Dr. Rubio says. “A lumbar strain can be not only muscular; there can also be a tear in the disk that causes inflammation.”

To avoid a lumbar strain while shoveling snow, Dr. Rubio advises using proper body mechanics. “Do not use your back. Instead, bend at your knees and use your legs to lift the snow as you extend your knees. You don’t want your back extending first,” he says. “You can also buy an ergonomic shovel to help alleviate stress from the lower part of your back.” 

4. Know when to seek medical attention for a spine injury.

While simple muscle strains or bruises from winter activities might heal with rest and home care, it’s important to contact your doctor if you have any concerns.

“Signs of significant injury that require urgent evaluation include any upper or lower extremity numbness, weakness, or significant pain, as well as loss of bowel or bladder function,” Dr. Rubio says. “For any of these issues, you should see a spine surgeon as soon as possible or be seen in your local emergency department. But if it’s minor, talk to your primary care physician, and they will make an appointment with a spine specialist if needed.”