How to Prevent Vertebral Compression Fractures

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Osteoporosis is a silent disease until it is complicated by a fracture (bone break) that can occur with little to no trauma. You often hear that osteoporosis and vertebral compression fractures go hand in hand, but what exactly is a compression fracture? Is there anything you can do to help prevent compression fractures from occurring?

Disclaimer: If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Well Guide contain information from peer-reviewed research, medical societies and governmental agencies; however, these articles are not a substitute for professional medical advice, diagnosis, or treatment.

What is a vertebral compression fracture?

According to the Mayo Clinic, compression fractures occur when your vertebrae (the bones in your spine) weaken to the point of failure. This can cause back pain, loss of height, and a hunched over posture (Mayo Clinic, 2021).

How common are vertebral compression fractures?

Vertebral compression fractures are the most common type of fracture resulting from osteoporosis, affecting over 700,000 Americans annually (McCarthy, 2016). Vertebral compression fractures affect 25% of postmenopausal women older than 50 years of age and 40% of women by age 80. A new vertebral compression fracture occurs every 22 seconds worldwide. The annual incidence of vertebral compression fractures is close to 1.5 million, and the estimated direct annual health care cost of managing osteoporotic spine and hip fracture is $10 to $15 billion (Goldstein, 2015).

What are risk factors for vertebral compression fractures?

Risk factors for vertebral compression fractures include osteopenia, osteoporosis, older age, a history of a previous vertebral compression fracture or falls, inactivity, use of corticosteroids, weight less than 117 lbs, female sex, consumption of greater than 2 alcoholic drinks per day in females or greater than 3 in males, smoking, vitamin D deficiency, and depression (McCarthy, 2016).

Why should you be worried about vertebral compression fractures?

Compression fractures are associated with significant morbidity and mortality. Compression fractures may cause height loss or posture that is stooped or hunched (Bone Health & Osteoporosis Foundation, 2018). They can also cause pain, reduced mobility and independence, as well as psychological distress. In addition, the long-term mortality of patients with a history of a vertebral compression fracture is significantly higher than the general population (Goldstein, 2015). Patients with vertebral compression fractures have a five-fold increased risk of future vertebral compression fractures and a two to three-fold increased risk of fractures at other sites (Bone Health & Osteoporosis Foundation, 2018).

What can you do to help prevent compression fractures?

Performing your everyday activities in a safe way can help prevent compression fractures by decreasing the load on your spine. Here are some tips for safe performance of your activities of daily living:

  • Always maintain proper posture, with your head stacked over your shoulders and your shoulders stacked over your hips. You should sit and stand with a neutral spine position, being careful to avoid slouched, or bent over, postures.
  • Avoid spinal flexion (bending over) during your everyday activities. Instead, bend at your hips and knees, keeping your spine straight. For example, when you bend forward to brush your teeth, bend from your hips with your back straight rather than bending your back.
  • Avoid spinal rotation during your everyday activities. Move your feet when you need to turn rather than twisting your back.
  • When lifting, make sure you bring objects close to your body, bend at your hips and knees rather than your back, and avoid lifting heavy loads.

In addition, appropriate postural exercises can help decrease your risk of vertebral compression fractures (Bone Health & Osteoporosis Foundation, 2018). For example, back extensor strengthening can improve strength and bone density and reduce the risk of future vertebral compression fractures (McCarthy, 2016). Proper posture and back extensor strengthening exercises are part of Wellen’s personalized exercise programs for osteoporosis.

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  1. Cosman F, de Beur SJ, LeBoff MS, et al. Clinician's Guide to Prevention and Treatment of Osteoporosis [published correction appears in Osteoporos Int. 2015 Jul;26(7):2045-7]. Osteoporos Int. 2014;25(10):2359-2381. doi:10.1007/s00198-014-2794-2.
  2. Compression fractures. Mayo Clinic. Accessed April 2, 2022.
  3. McCarthy J, Davis A. Diagnosis and Management of Vertebral Compression Fractures. Am Fam Physician. 2016;94(1):44-50.
  4. Goldstein CL, Chutkan NB, Choma TJ, Orr RD. Management of the Elderly With Vertebral Compression Fractures. Neurosurgery. 2015;77 Suppl 4:S33-S45. doi:10.1227/NEU.0000000000000947.
  5. Boning up on osteoporosis. Bone Health and Osteoporosis Foundation. Updated March 2018. Accessed August 7, 2022.

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