Compression Fracture in the Middle Back

Compression fractures are a common source of back pain, particularly for individuals over age 60. They most often occur in the thoracic spine (middle back) but can also occur in the cervical or lumbar spine. This page discusses the causes, risk factors and treatments of compression fractures in the thoracic spine (middle back).

What is a compression fracture?

Aging, injuries and other conditions (such as cancer) can cause tiny cracks to form in the vertebra. Eventually, these hairline fractures can weaken the vertebra and cause them to collapse on one another. This collapse is called a spinal compression fracture. 

Compression fractures are most commonly caused by osteoporosis, which makes bones brittle and weak. This increases the risk of fractures as your bones aren’t as strong as they once were. Every day activities, such as bending or carrying objects, can place too much stress on your back and cause hairline cracks to appear. Slipping or falling can also cause tiny cracks along the vertebra.

What are symptoms of compression fractures?

Back pain is the most common sign of a compression fracture. However, some individuals may not realize they have a compression fracture as they think back pain is a normal part of aging. It’s important to talk to your doctor about back pain that doesn’t improve, or if you experience any of the following symptoms:

  • Pain the worsens when walking or standing
  • Difficulty bending or twisting
  • Loss of height
  • Kyphosis (a curved, stooped shape to the spine)

How are compression fractures treated?

There are many approaches to treating spinal compression fractures. Your doctor will discuss the treatment that’s right for you depending on the severity of the fracture and your risk of additional fractures. Treatment options range from rest to minimally invasive surgical procedures.

Pain management

The goal of pain management is to help improve symptoms and alleviate your discomfort. Your doctor may also discuss other pain relief options, including prescription medication, cortisone injections or nerve blocks. Closely follow your physician’s instructions and read all medication labels to ensure you are taking medicine safely and effectively.

Physical therapy 

Physical therapy for spinal fractures includes exercises that strengthen your back and other parts of your body. Your physical therapist will also show you how to adapt every day activities to reduce painful symptoms and prevent additional fractures. This is often the first stop on your road to being pain free. 

Back brace

Your doctor may recommend that you wear a back brace while the fracture heals. This helps stabilize your spine to prevent further damage to vertebra.

Do I need surgery for compression fractures?

Your doctor may recommend surgical approaches to help the spinal fracture heal. Two common procedures include kyphoplasty and vertebroplasty.

Kyphoplasty

Kyphoplasty treats both the cracks in the vertebra and restores the vertebra to its original position. (The tiny fractures in the spine can cause vertebra to collapse onto each other, causing pain.) 

During the procedure, your surgeon will insert a balloon-like device into your spine through a small needle. The balloon-like device is used to “pump” the vertebrae back to its original height. This helps relieve the pain caused from vertebra rubbing against each other, improves range of movement and reduces your risk of a pinched nerve. 

Next, a specially-formulated cemented is injected into the cracks of the vertebrae. This mixture helps the fracture heal and strengthens the vertebrae. Kyphoplasty is an outpatient procedure, which allows you to return home the same day.

Vertebroplasty

During a vertebroplasty, your surgeon fills cracks in the spine with a special cement to help strengthen the bone. It is a minimally-invasive procedure that generally takes one to two hours. You will receive a local anesthesia to numb the area where the needle is inserted. Vertebroplasty is an outpatient procedure, which allows you to return home the same day.

How are compression fractures diagnosed?

Spinal compression fractures are diagnosed with a physical examination by your provider. Your doctor will ask you how long you have been experiencing pain, review your medical history and examine your spine. 

Imaging tests, such as X-ray, magnetic resonance imaging (MRI) or computerized tomography (CT) scan, may also be needed to identify the location and severity of the compression fracture.