Dealing with vertebral compression Fractures – Types, Causes, and Recovery

At Spine PT, we only deal with fractures or broken bones that are related to the head or spine – including the scapula, sacrum and tailbone.  For any fractures in your arms or hips/legs, you will want to see a general physical therapy clinic that can help you on your healing journey.  If your fracture is connected to the spine, then keep reading.

 Whether you have a minor hairline fracture or a more severe break, understanding fractures is crucial for proper treatment and recovery. In this blog, we’ll explore some fractures in and connected to the spine in detail, covering their types, causes, treatment options, and the path to a full recovery. 

Fractures need a period of stabilization to allow the bone to heal before beginning physical therapy.  This is usually about 6-8 weeks.  After this period, the doctors will release patients to begin movement through physical therapy.  

Types of Fractures of the spine:

• Compression fracture: This is the most common one we see and is generally caused from osteoporosis or a tumor that made the vertebra weak. Most patients report they sneezed, coughed, or even just leaned forward in their chair to pick up a cup.  Traumatic injuries can also cause a compression fracture.  A compression fracture is typically a hairline fracture that shows up on an x-ray as a crack in the vertebra but the vertebra is still together. 
• Burst fracture: This happens when the spine is loaded down through the spine – caused from something like falling from a significant height and landing on the feet.  As the name suggests, the vertebra bursts under all the pressure.  The severity ranges from mild cracking throughout the vertebra to significant crushing of the vertebrae into pieces.
• Chance fracture: This is also referred to as a flexion-distraction fracture or seatbelt fracture because it is common in car accidents where a person bends forward violently at high speeds.  
• Fracture-dislocation: A high-velocity injury also found in car accidents that cause fractures in the vertebra, but also dislocation of the facet joints (the little joints that connect the vertebra together).  The vertebra is displaced from its normal position due to a rotational or sideways force.  This usually requires surgical intervention to stabilize the spine to keep from being paralyzed.  

Recognizing the symptoms of a fracture is crucial for timely treatment. Symptoms often include severe pain at the fracture site.  Vertebral fractures often don’t involve any swelling or bruising – just sharp pain along the spine.  Fractures in the head/jaw or tailbone area can have swelling and bruising.  

The diagnosis of a fracture typically involves a physical examination and imaging tests, such as X-rays or MRI. Treatment options vary depending on the type and severity of the fracture. Immobilization by wearing a large, rigid back brace to keep you from bending or twisting in any direction is the first thing most doctors will do to help the back heal.

Recovery from a fracture often involves rehabilitation. Physical therapy plays a crucial role in this process but which type of therapist you should see depends on your goals.  In the rare situation you aren’t having significant pain and are more concerned with your mobility and weakness in your legs, then a general physical therapy clinic will be where you will want to go.  They will help you regain your mobility in a way to keep your back safe.  If however your main concern is treating your pain and learning how to prevent future compression fractures, you will want to see one of our highly trained physical therapists that have been trained in advanced techniques to address your back pain and teach you how to protect your spine from future fractures. 

A patient come to see us who had 6 different compression fractures in one year before she was referred to Spine PT.  Each new fracture would cause severe pain and she would be unable to get out of bed for 4-5 weeks.  When the pain let up enough that she could get out of bed, she would attempt to return to some normal daily activities while wearing a large, heavy back brace to protect her back.  Even with wearing the brace, she would cough or lean forward in her chair to pick up a cup and cause another fracture.  After 6 fractures in one year, she had become scared to move. She had been to a couple general physical therapy clinics but they would never address her back pain.  They never removed her back brace and only focused on her mobility and leg strength.

At her first treatment Spine PT, she was surprised we took off her back brace and actually treated her back while keeping it in a safe position.  After her first visit, her pain had decreased by over 60%.  Within 5 visits, this patient was feeling amazing and was no longer scared to move or scared to cough or sneeze.  

Most back pain that people are experiencing after 4-6 weeks is no longer from the fracture, but from the muscles, fascial tissue, and restricted facet joints along the spine.  How do we know this? Because when we address these soft tissues, the pain significantly reduces or goes completely away.  

How did this patient regain her confidence to begin living her life again without the constant fear she would move wrong and cause another fracture?  Here are some of the things she was taught:

1. Multiple correct sitting postures. 

Sitting correctly is NOT what we have been taught.  It’s not just about sitting up tall and keeping our shoulders back.  While that may look “proper,” it has nothing to do with keeping your back safe from injuries.  Our definition of sitting correctly at Spine PT is different.  We teach our patients to sit in positions that have less strain on the vertebra and discs that will not only protect them from injury but promote healing.

2. Multiple correct sleeping positions that kept the spine in a neutral position so the vertebra could heal.  

Yes, sleeping in positions that have less strain on the discs and vertebra is important to help your spine heal.  Certain sleeping positions can further weaken vertebra, making them more prone to fractures.

3. How to get up and down from sitting and safer ways to do daily activities.

4. How to protect the back from the strain that comes with coughing, sneezing, and having a bowel movement. 

There are many things that can be done to help reduce the pain from a fracture – while keeping it immobilized and protected but you need to see a physical therapist who has been trained and knows how to coach you.  

Preventing fractures is the key. If you have osteoporosis or osteopenia, you need to maintain a balanced diet rich in calcium and vitamin D and avoid ALL soda.  Soda has phosphoric acid that will block the absorption of calcium. Engaging in weight-bearing exercises helps strengthen bones and improve overall bone density. When participating in activities or sports, it’s crucial to use proper safety equipment to reduce the risk of injuries. 

Understanding fractures is vital for their effective treatment and recovery. If you or a loved one has experienced a fracture, seeking professional care promptly is essential. At Spine PT, located in Lehi, Sandy, and soon to be Orem, our experienced team is dedicated to providing comprehensive fracture rehabilitation and support. Contact us today at 801-709-4772 to schedule a consultation and begin your journey to a full recovery. Your health and well-being are our top priorities, and we’re here to guide you every step of the way.