Introduction
A vertebral compression fracture, known as kotkompression in Swedish, occurs when a bone in the spine (vertebra) collapses or is compressed. This condition is most common in older adults, especially those with osteoporosis, but can also result from trauma or certain diseases. Early recognition and appropriate management are essential to relieve pain, prevent further fractures, and maintain spinal health.
Causes
Vertebral compression fractures can result from several factors:
- Osteoporosis: The most common cause, where weakened bones are more susceptible to fracture, even with minor stress or falls.
- Trauma: High-impact injuries, such as falls, car accidents, or sports injuries, can cause compression fractures in healthy bones.
- Cancer: Tumors that spread to the spine can weaken the vertebrae and lead to fractures.
- Other Diseases: Conditions such as infections or metabolic bone diseases.
Symptoms
The main symptoms of a vertebral compression fracture include:
- Sudden Back Pain: Sharp or severe pain in the back, often after a minor fall or movement.
- Pain Worsening with Movement: Pain increases with standing, walking, or lifting.
- Loss of Height: Gradual loss of height over time due to multiple fractures.
- Spinal Deformity: Development of a stooped posture or kyphosis (hunchback).
- Limited Mobility: Difficulty bending, twisting, or performing daily activities.
- Nerve Symptoms: In rare cases, numbness, tingling, or weakness in the legs if nerves are compressed.
Diagnosis
Diagnosis is based on clinical evaluation and imaging:
- Medical History: Review of symptoms, risk factors, and any previous injuries or medical conditions.
- Physical Examination: Assessment of spinal tenderness, posture, and mobility.
- Imaging: X-rays are the primary tool to detect compression fractures. MRI or CT scans may be used to assess the extent of the fracture and rule out other causes, such as tumors.
Treatment Options
Treatment depends on the severity of the fracture and underlying cause:
- Pain Relief: Over-the-counter pain relievers such as paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs).
- Rest and Activity Modification: Short periods of rest followed by gradual return to activity.
- Bracing: Wearing a back brace to support the spine and reduce pain.
- Physical Therapy: Exercises to strengthen back muscles, improve posture, and restore mobility.
- Osteoporosis Management: Medications and lifestyle changes to strengthen bones and prevent future fractures.
- Minimally Invasive Procedures: In some cases, procedures such as vertebroplasty or kyphoplasty may be performed to stabilize the fracture and relieve pain.
- Surgical Intervention: Rarely needed, but may be required for severe fractures with nerve involvement or spinal instability.
Prevention
Preventive strategies focus on maintaining bone health and reducing the risk of falls:
- Osteoporosis Screening and Treatment: Regular bone density tests and appropriate medications for those at risk.
- Calcium and Vitamin D: Ensure adequate intake to support bone strength.
- Regular Exercise: Weight-bearing and muscle-strengthening exercises.
- Fall Prevention: Remove tripping hazards, use assistive devices if needed, and maintain good vision and balance.
- Healthy Lifestyle: Avoid smoking and excessive alcohol consumption.
Takeaway
Vertebral compression fractures are a common cause of back pain, especially in older adults with osteoporosis. Early diagnosis, pain management, and measures to strengthen bones can help prevent further fractures and maintain quality of life. If you experience sudden back pain or notice a change in posture, consult a healthcare provider for evaluation and personalized care.