Spinal Fractures: Symptoms, Causes, Diagnosis, Treatment and Outlook — What You Need to Know
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Medical emergency: If you have had a high-impact trauma (such as a fall or car accident), or you have a sudden loss of bladder or bowel control, seek emergency medical attention immediately. These can be signs of a severe spinal fracture or spinal cord injury that needs urgent treatment.
Quick Answer: What is a spinal fracture?
A spinal fracture is a break in one or more vertebrae, the bones that protect the spinal cord and support the body. Fractures are described by location in the neck, upper back or lower back and by stability; unstable fractures shift the vertebrae and greatly increase the risk of spinal cord injury. [1] Osteoporosis and trauma are major causes. [1]
What the research says
One vertebral fracture sharply raises the risk of another. In an analysis of 2,725 postmenopausal women in osteoporosis trials, having one or more vertebral fractures at baseline raised the risk of a new vertebral fracture in the following year about 5-fold (relative risk 5.1; 95% CI 3.1 to 8.4). Among the 381 women who developed a new fracture, 19.2% had another within the next year (Lindsay et al., JAMA, 2001) [2].
Vertebral fractures are often missed. In 2,451 postmenopausal women with osteoporosis, 32% had at least one vertebral fracture on central radiograph review, and the false-negative rate of the original local readings was 34%, with underdiagnosis seen in every region studied (Delmas et al., J Bone Miner Res, 2005) [3].
Bone cement for osteoporotic fractures has not shown clear benefit over a sham procedure. A Cochrane review of 21 trials found high- to moderate-quality evidence that vertebroplasty gave no clinically important benefit in pain, disability, or quality of life at one month compared with a sham procedure (5 trials, 541 participants), and serious adverse events reported with vertebroplasty included osteomyelitis and cord compression (Buchbinder et al., Cochrane Database Syst Rev, 2018) [4].
What are the types of spinal fractures?
Healthcare providers classify spinal fractures by the mechanism of injury and the resulting bone pattern. Knowing the type of fracture is essential for choosing treatment and assessing the risk to the spinal cord.
Fracture Type | Description and Mechanism |
|---|---|
Compression fracture | Small breaks or cracks caused by trauma or that develop over time from osteoporosis [1] |
Burst fracture | The vertebra breaks into many pieces when the spine is suddenly compressed by a strong force (for example, falling and landing upright on your feet) [1] |
Chance fracture | Also called a flexion/distraction fracture; the vertebrae are pulled apart, often in car accidents when a seatbelt catches the lower body and the upper body is jerked forward [1] |
Stable fracture | The broken vertebrae stay in their usual alignment; surgery is less likely [1] |
Unstable fracture | The injury moves the vertebrae out of alignment; surgery is much more likely and the risk of spinal cord complications is higher [1] |
What are the symptoms and warning signs of a spinal fracture?
Spinal fracture symptoms vary with whether the break was sudden or gradual and can include back pain, posture changes, height loss and numbness. Many people never notice a compression fracture, especially when it develops over time from osteoporosis. [1] If you do have symptoms, they can include:
Back pain: A sharp, intense pain that may get worse over time, especially when walking or moving. [1]
Swelling or tenderness: The area around the broken vertebrae may be swollen and painful to touch. [1]
Posture changes: A new slump or stoop, medically called kyphosis. [1]
Tingling or numbness: A feeling that may run down the arms or legs. [1]
Height loss: Becoming noticeably shorter over time, sometimes up to 6 inches. [1]
Incontinence: A new loss of bladder or bowel control [1], which is a potential medical emergency.
What causes spinal fractures, and who is at risk?
Spinal fractures are most commonly linked to chronic bone weakening or sudden physical trauma. [1]
Osteoporosis: Bones lose density and strength over time, which raises the risk of many types of fractures, including compression fractures. [1]
Physical trauma: A sudden intense force, such as a car accident, a fall, or a sports injury, can exceed what the spine can tolerate. [1]
Spinal tumors: Most spinal tumors result from cancer that has spread from another area of the body, and they can weaken the vertebrae. [1]
Risk Factor | Impact on Spinal Health |
|---|---|
Age and sex | Females and adults older than 50 are more likely to have spinal fractures [1] |
Osteoporosis | Much higher likelihood of compression fractures; after one compression fracture you are about five times more likely to have another [1] |
Medications | Long-term use of corticosteroids [1] |
Chronic disease | Cancer (especially with chemotherapy or radiation), hyperthyroidism, kidney disease, and bone infections (osteomyelitis) [1] |
Lifestyle habits | Smoking and drinking too much alcohol [1] |
Nutritional factors | Vitamin D deficiency and anorexia nervosa [1] |
How are spinal fractures diagnosed?
Providers diagnose a spinal fracture with a physical exam and imaging tests. [1] They look at your back, feel for tender or painful spots, and check for changes in the shape of your spine and your posture. [1] Tell them exactly where you hurt and when you first noticed new pain.
X-rays: Confirm the fracture and show how far the bones are out of place. [1]
CT scan: Gives a more detailed picture of the bones, which matters if surgery is needed. [1]
MRI: Shows the spinal cord, nerves, and surrounding tissue, and whether the cord is at risk of damage. [1]
Bone density test (DEXA): Likely to be done to check for osteoporosis and how much it has weakened your bones. [1]
How are spinal fractures treated and managed?
How a fractured spine is treated depends on what caused the fracture, the type of fracture, and where the broken vertebrae are. [1] The goals are to stabilize the spine, relieve pain, and prevent neurological complications.
Non-surgical approaches
Most spinal fractures don't need surgery. [1] The most common treatments are:
Bracing: A back brace holds the spine in alignment while the vertebrae heal. Most people wear one for a few months. [1]
Physical therapy: Strengthening the back muscles improves strength, helps reduce bone loss, and lowers the risk of future fractures. [1]
Treating osteoporosis: If you have osteoporosis, your provider may prescribe medicine or supplements to strengthen your bones. [1]
Pain management: Over-the-counter NSAIDs are often all that is needed. Talk to your provider before taking them for more than 10 days in a row. [1]
Surgical interventions
Surgery may be needed if the fracture is in danger of damaging the spinal cord, or if pain doesn't improve a few months after non-surgical treatment. The most common surgeries are vertebroplasty, in which liquid cement is injected into the fractured vertebra to strengthen it, and kyphoplasty, which is similar but uses a tiny balloon first to push the bone back into place and re-create the space that was there before the fracture. [1] Spinal fusion, which connects two or more vertebrae with rods and screws, may be used for unstable injuries.
What is the outlook after a spinal fracture?
If the fracture didn't damage the spinal cord, nerves, or surrounding tissue, you shouldn't have long-term effects. [1] Most spinal fractures heal in around three months without surgery. [1] People who need surgery will need longer, up to about six weeks to recover from the surgery and then a few more months for the spine to heal. [1]
Severe fractures, especially unstable ones, can damage the spinal cord and affect your ability to stand or walk, and this damage might be permanent. [1] If you were diagnosed with osteoporosis after your fracture, you will need regular bone density screening. [1] Once you have had one osteoporotic compression fracture, you are about five times more likely to have another [1], so ongoing bone-health management is essential.
How can you prevent spinal fractures and protect bone health?
Many spinal fractures related to bone density can be prevented with bone density testing, good nutrition, weight-bearing exercise, fall prevention and safety habits.
Bone density testing: Talk to your provider about a bone density test if you are older than 50 or have a family history of osteoporosis. [1]
Nutrition and exercise: A diet rich in calcium and vitamins C and D, plus weight-bearing exercise such as walking, jogging, aerobics, or lifting weights, supports bone strength. [1]
Fall prevention: Keep your home and workspace free of clutter, never stand on chairs or tables to reach things, and use a cane or walker if you are at higher risk of falling. [1]
Safety habits: Always wear a seatbelt with the shoulder harness, and use the right protective equipment for sports and activities. [1]
Lifestyle: Quit smoking and limit alcohol.
Get new symptoms or changes in your back checked as soon as possible, including pain, swelling, discoloration, tenderness, or a noticeable change in your height or posture. [1] Go to the emergency room right away after trauma. [1]
Frequently Asked Questions
Can you walk with a broken back?
Often, yes, depending on the type and cause of the fracture. If the fracture wasn't caused by sudden trauma, you can likely still move, although it may be painful. You won't be able to walk if the fracture damaged your spinal cord enough to cause paralysis.
How long does it take for a spinal fracture to heal?
Most spinal fractures heal in around three months if you don't need surgery, often with a back brace worn for a few months. People who need surgery need longer: up to about six weeks to recover from the surgery, then additional months for the spine to heal. Your provider will give you a timeline for your case.
Is a spinal fracture the same as a herniated disc?
No. A spinal fracture is a break in the vertebral bone itself. A herniated disc involves the soft, gel-like center of a spinal disc pushing through a tear in the tougher exterior, which can press on nearby nerves.
What is the most common cause of spinal fractures?
Osteoporosis is the most common cause, leading to more than 1.5 million compression fractures a year in the United States. More than 150,000 spinal fractures a year are caused by trauma such as falls, sports injuries, and car accidents.
What happens if a spinal fracture is left untreated?
An untreated fracture can cause lasting pain, changes in posture (kyphosis), and height loss, and unstable fractures can threaten the spinal cord. See a provider as soon as possible for new back pain, swelling, or changes in your height or posture.
Can a spinal fracture cause paralysis?
Yes. Severe fractures, especially unstable ones, can damage the spinal cord and affect your ability to stand or walk. This damage might be permanent and irreversible.
What is the difference between vertebroplasty and kyphoplasty?
Both involve injecting liquid cement into a fractured vertebra. In kyphoplasty, the surgeon first inserts a tiny balloon and inflates it to push the bone back into place and re-create the space that was there before the fracture.
Are spinal fractures more common in men or women?
Females and adults older than 50 are more likely to experience spinal fractures, in part because osteoporosis is a leading cause.
Does smoking affect spinal fractures?
Smoking is one of the risk factors for spinal fractures, along with drinking too much alcohol. Quitting smoking and limiting alcohol support bone health.
Can a minor fall cause a spinal fracture?
In people with osteoporosis, compression fractures can develop gradually over time without major trauma, and many people never notice them. Sudden trauma such as a fall or car accident is more likely to cause burst and Chance fractures.
How is an unstable fracture different from a stable one?
A stable fracture doesn't push or pull the vertebrae out of their usual alignment. An unstable fracture moves the vertebrae out of alignment, is more serious, and carries a much higher chance of needing surgery and a higher risk of spinal cord complications.
Do all spinal fractures require surgery?
No. Most spinal fractures don't need surgery and can be treated with bracing and physical therapy. Surgery is considered if the fracture could damage the spinal cord or if pain doesn't improve a few months after non-surgical treatment.
What are the signs of a spinal cord injury after a fracture?
Warning signs include a sudden loss of bladder or bowel control, numbness, tingling, or weakness in the arms or legs. Seek emergency care right away.
Can exercise help prevent spinal fractures?
Exercises that make your muscles work against gravity, such as walking, jogging, aerobics, and lifting weights, strengthen your bones. Together with a diet rich in calcium and vitamin D, they support bone health and help reduce the risk of osteoporosis.
Is height loss always a sign of a spinal fracture?
No, but noticeable height loss (sometimes up to 6 inches over time) can be a sign of compression fractures, especially from osteoporosis. Talk with your provider about a change in your height or posture.
References
Cleveland Clinic. Fractured spine (vertebrae). Cleveland Clinic. September 12, 2022. https://my.clevelandclinic.org/health/diseases/17498-spinal-fractures
Lindsay R, Silverman SL, Cooper C, et al. Risk of new vertebral fracture in the year following a fracture. JAMA. 2001;285(3):320–323. PMID 11176842. https://doi.org/10.1001/jama.285.3.320
Delmas PD, van de Langerijt L, Watts NB, et al. Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT study. J Bone Miner Res. 2005;20(4):557–563. PMID 15765173. https://doi.org/10.1359/JBMR.041214
Buchbinder R, Johnston RV, Rischin KJ, et al. Percutaneous vertebroplasty for osteoporotic vertebral compression fracture. Cochrane Database Syst Rev. 2018;11(11):CD006349. PMID 30399208. https://doi.org/10.1002/14651858.CD006349.pub4
Medical Disclaimer
This article is for informational purposes only and does not constitute medical advice. If you have had a traumatic injury or have severe back pain, consult a qualified healthcare provider for an accurate diagnosis and treatment plan.
Comments