Compression Fractures

By: Gcina Gumede

Compression fractures refer to the collapse or compression of a vertebral body, which is a bone in the spine. They are typically found in the thoracic region of the spine which is the middle of the back. Compression fractures are commonly found in osteoporotic individuals which is a condition characterized by a decrease in bone density, making the bones more susceptible to fractures.

Although compression fractures are common in people with osteoporosis, compression fractures can also result from traumatic injuries, such as falls, accidents, or sports injuries. Aging also makes people susceptible to compression fractures. Women over the age of 50 years are the must susceptible to compression fractures. Research show that 1 in 4 women suffers from compression fractures. Bone density decreases after menopause primarily due to hormonal changes, specifically a decline in oestrogen levels. Oestrogen plays a crucial role in maintaining bone health, and its reduction significantly affects bone density. Here’s how this process occurs.

• Less Oestrogen: Oestrogen helps maintain bone density. With its decrease, bone breakdown increases, leading to lower bone density.
• Poor Calcium Absorption: Oestrogen helps absorb calcium, crucial for bone strength. With less oestrogen, calcium absorption drops, further weakening bones.
• Vitamin D Changes: Vitamin D aids in calcium absorption. Menopause can affect its metabolism, reducing its effectiveness in maintaining bone health.
• Imbalanced Bone Remodelling: Oestrogen normally balances the process of old bone being replaced with new bone. With its decline, more old bone is broken down than new bone is formed, leading to bone density loss.
• Aging Factor: Menopause coincides with middle age when bones naturally weaken. Hormonal changes during menopause speed up this process.

Symptoms

• Back pain: Usually relieved by laying down. It worsens when you are standing upright.
• Decrease spinal mobility: You may struggle or unable to bend or twist your spine.
• Stooped posture: Compression fractures may lead to an individual having a posture that is hunched over in order to put as little pressure on the vertebrae. 
• Decreased height: This is caused because of the collapsed vertebrae.

Test/Diagnosis of Compression Fractures

A compression fracture examination typically involves a thorough physical assessment, including evaluation of the patient’s medical history, symptoms, and any recent trauma. Diagnostic imaging such as X-rays, CT scans, or MRI scans may be utilized to confirm the presence of a compression fracture, assess its severity, and identify any associated complications such as nerve compression or spinal instability. Neurological examination may also be conducted to assess for any neurological deficits or abnormalities.

Treatment options, including pain management, bracing, physical therapy, or surgical intervention, are then considered based on the findings of the examination and the individual patient’s needs and circumstances.

Exercise and Compression Fractures

Exercise can play a crucial role in the management and prevention of compression fractures, especially in osteoporotic individuals who are at increased risk. However, it’s essential to approach exercise with caution and under the guidance of a healthcare professional to prevent further injury. Low-impact exercises such as walking, swimming, or cycling can help improve bone density, strengthen muscles supporting the spine, and enhance overall balance and coordination, reducing the risk of falls and subsequent fractures.

Additionally, exercises focusing on core stability and posture can help alleviate strain on the spine and promote proper alignment, potentially reducing the likelihood of compression fractures. It’s important to avoid high-impact activities and movements that involve twisting or bending the spine excessively, as these can increase the risk of further injury. Always consult with a Biokineticist to develop a safe and appropriate exercise regimen tailored to individual needs and limitations.

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