Vertebral Compression Fractures: Symptoms, Causes, and Kyphoplasty

A vertebral compression fracture is a small break that causes one of the bones in your spine to collapse and lose height. It sounds alarming, and the sudden back pain can be intense — but many of these fractures heal, and there’s a minimally invasive procedure that can relieve the pain quickly when they don’t. This guide explains what a compression fracture is, why it usually happens, and how it’s treated.

What is a vertebral compression fracture?

A vertebral compression fracture happens when one of the vertebrae — the stacked bones of the spine — cracks and collapses, usually at the front, so the bone becomes wedge-shaped and shorter. They most often occur in the middle back (the thoracic spine). Because weakened bone can give way during everyday movements, these fractures are common in older adults.

Symptoms of a compression fracture

The most common sign is sudden back pain, often triggered by a minor movement like bending, lifting, or even a cough. Other symptoms build up over time, especially when someone has had more than one fracture:

• Back pain that’s worse when standing or walking and better when lying down
• Loss of height over months or years
• A gradually stooped-forward posture (sometimes called a “dowager’s hump”)
• Limited movement and difficulty bending or twisting

Some compression fractures cause surprisingly little pain and are found by chance on an X-ray taken for another reason.

What causes compression fractures, and who’s at risk?

By far the most common cause is osteoporosis — the thinning of bone that makes it fragile. When bone is weak enough, a fracture can happen with little or no force. Less commonly, compression fractures come from a significant injury like a fall or car accident, or from a tumor weakening the bone. The people most at risk are older adults, especially women after menopause, and anyone who has already had one compression fracture. If a fracture happens after a car accident or fall, our back pain team also treats injury-related spine pain.

How is a compression fracture diagnosed?

Diagnosis usually starts with an X-ray, which can show a collapsed, wedge-shaped vertebra. An MRI adds detail — it can tell whether a fracture is new or old and whether a nerve is involved. Because osteoporosis is so often the underlying cause, a bone density (DEXA) scan is frequently done as well, so the bone loss driving the fracture can be treated. Diagnosing the fracture and the bone health together is what prevents the next one.

How are compression fractures treated?

Many compression fractures are first managed without surgery, and a good number heal on their own over time. As Cleveland Clinic notes, “some types of compression fractures can heal on their own,” though “healing can take several months” (Cleveland Clinic).

Conservative care

Non-surgical treatment usually includes a period of rest and activity modification, pain-relieving medication, and sometimes a back brace to support the spine while it heals. Just as important, treating the underlying osteoporosis with the right medication helps the bone recover and lowers the chance of another fracture.

When pain doesn’t settle

If the pain stays severe despite conservative care — or a patient can’t tolerate weeks of limited movement — a minimally invasive procedure called kyphoplasty can relieve it. That’s covered next.

Surgery

Traditional open surgery is uncommon and is generally reserved for fractures that are unstable or pressing on the spinal cord or nerves.

What is kyphoplasty?

Kyphoplasty is a minimally invasive procedure that treats a painful compression fracture. Through a small opening, the doctor guides a thin tube into the collapsed vertebra, gently inflates a small balloon to create space and help restore some height, then fills that space with a special bone cement that hardens to stabilize the bone. Many patients feel meaningful pain relief soon after. You can read more about the procedure and what to expect on our kyphoplasty and vertebroplasty page. Because compression fractures and other worn-spine conditions can overlap, our guide on spinal stenosis may also be helpful if you have ongoing back and leg symptoms.

When should you see a doctor?

See a doctor for sudden, unexplained back pain — especially if you’re over 50, have osteoporosis, or have noticed loss of height or a more stooped posture. Prompt evaluation helps the fracture heal correctly and gets the underlying bone loss treated.

Frequently asked questions

How long does a compression fracture take to heal?

Many compression fractures heal within about three months, and pain often begins to improve after the first few weeks with proper care. Healing time varies with the fracture and your bone health, which is why treating any underlying osteoporosis matters.

Is kyphoplasty worth it for a compression fracture?

For the right patient — someone with a painful fracture that hasn’t settled with conservative care — kyphoplasty can provide fast, meaningful pain relief and help stabilize the bone. Whether it’s the right choice depends on your specific fracture, so it’s decided case by case with your doctor.

Can you walk with a compression fracture?

Many people can still walk, though standing and walking often make the pain worse while lying down eases it. Your doctor will guide how much activity is safe, since too much rest has its own downsides and gentle movement is usually encouraged as healing allows.

What happens if a compression fracture goes untreated?

Some heal on their own, but untreated fractures — especially several over time — can lead to lasting height loss, a stooped posture, and ongoing pain. Untreated osteoporosis also raises the risk of more fractures, so getting evaluated is worthwhile even if the pain is tolerable.

What’s the difference between kyphoplasty and vertebroplasty?

Both inject bone cement to stabilize a fractured vertebra and relieve pain. The main difference is that kyphoplasty first inflates a small balloon to create space and help restore height before the cement is placed, while vertebroplasty injects the cement without the balloon step.

This article is for general education and is not a substitute for medical advice. Talk with a qualified clinician about your specific symptoms.