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Causes of Spinal Compression Fractures

If you're nearing age 60 and have back pain, don't assume it's a normal part of getting older. You could be affected by a spinal compression fracture.

Back aches and pains can be a sign that small fractures are occurring in your vertebrae - the bones that form your spine. Soft, weakened bones are at the heart of this problem. Compression fractures are often caused by bone-thinning osteoporosis, especially if you are a postmenopausal woman over age 50.

When bones are brittle, everyday activities can trigger minor spinal compression fractures. When you bend to lift an object, miss a step, or slip on a carpet, you can put your spinal bones at risk of fracture. Even coughing or sneezing can cause compression fractures in more severe cases of osteoporosis.

After a number of small compression fractures, your body begins to show the effects. The small hairline fractures can eventually cause a vertebra to collapse -- called spinal compression fracture.

These tiny fractures can permanently alter the strength and shape of the spine. You lose height because your spine is shorter. Most compression fractures occur in the front of the vertebra, which causes the front part of the bone to collapse creating a wedge-shaped vertebra. The back of the bone is unchanged because it's made of harder bone. This creates the stooped posture called kyphosis, or dowager's hump.

About two-thirds of spinal compression fractures are never diagnosed because many patients and families think the back pain is merely a sign of aging and arthritis. In fact, many people put off seeing a doctor because they don't realize what's wrong, experts say. But if osteoporosis isn't treated, it can lead to future fractures -- and possibly more severe compression fractures. Osteoporosis treatment significantly reduces but does not eliminate the chance of developing another compression fracture.

Each spinal compression fracture can cause increased lung and breathing problems and even early death. The pain from fractures that don't heal can lead to depression. And continued use of pain medication can cause constipation, which can worsen the depression. And the growing number of fractures can sometimes lead to a person being placed in a nursing home. 

Who Is at Highest Risk for Spinal Compression Fractures?

Two groups of people are at highest risk for spinal compression fractures:

  • People with the bone-weakening disease osteoporosis.
  • People with cancer that has spread to their bones.

If you have been diagnosed with certain kinds of cancer -- including multiple myeloma and lymphoma -- your doctor may monitor you for compression fractures. However, sometimes a spinal fracture may be the first indication of cancer.

But if you have osteoporosis, you may not even know it.

Here are the leading risk factors for osteoporosis:

  • Race: White and Asian women have the greatest risk.
  • Age: The risk rises rapidly in women over 50 and increases with age.
  • Weight: Thin women are at higher risk.
  • Early Menopause: Women who went through menopause before age 50 have higher risk.
  • Smokers: People who smoke lose bone thickness faster than nonsmokers.

Statistically, among people over age 50, osteoporosis strikes:

  • 20% of white and Asian women
  • 10% of Hispanic women
  • 5% of black women
  • 5% of men

And among those who develop compression fractures, studies indicate they face a 23% increase in mortality.

 

WebMD Medical Reference

Reviewed by David T. Derrer, MD on February 23, 2014
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