Vertebral Compression Fracture & Osteoporosis-Related Spine Fractures

A vertebral compression fracture is a collapsed bone in your spine. It most often happens when bones have become thin from osteoporosis, sometimes after a minor fall or even a cough. Most heal within 6 to 12 weeks with pain relief, a brace if needed and treatment of the bone, and only a few need a procedure or surgery.

Reviewed by Dr. Kshitij Chaudhary, Last reviewed October 2026

What is a vertebral compression fracture?

A vertebra is one of the bones of the spine. In a compression fracture, it cracks and collapses, usually at the front, so the bone becomes wedge-shaped. Unlike a fracture from a major accident, it can happen with a cough, a bend or a minor fall, or with no clear trigger. These fractures are common in older adults, and they are often missed because the pain is mistaken for ordinary back strain.

What causes it?

• Osteoporosis: by far the most common cause, especially after menopause and in older men. See Osteoporosis
• Injury: a bigger fall or accident, even in people without osteoporosis
• Long-term steroid tablets, which thin the bones
• A tumour in the bone, called a pathological fracture. See Spinal Metastasis
• Infection, rarely. See Spinal Tuberculosis

Who gets it?

It is most common in women after menopause and in men over 70. Anyone with osteoporosis, long-term steroid use or other risk factors for thin bones is at higher risk.

How serious is it?

It can be very painful, but most of these fractures heal. The bigger concern is the next fracture, because one fracture raises the chance of another. Several fractures over the years cause loss of height and a stooped upper back. Occasionally a fracture presses on the nerves, which is covered below.

What are the symptoms?

• Sudden back pain, often after a minor strain, a cough or a fall, or with no clear trigger
• Pain in one spot, worse when you stand, walk or bend, and better lying down
• Loss of height and a stooped, hunched upper back over time
• Pain that slowly eases over several weeks

How is it diagnosed?

• X-ray: usually the first test. It shows the collapsed or wedge-shaped bone
• MRI: shows how recent the fracture is, whether nerves are pressed, and whether a tumour or infection could be the cause
• DEXA scan and blood tests: confirm osteoporosis and check calcium, vitamin D, thyroid and kidney function, so we find any cause that can be treated

Will it get worse?

The pain usually eases over 6 to 12 weeks as the bone heals. A small number of people are left with some height loss or a rounded upper back. The risk of another fracture is real, which is why treating the bone is as important as healing this fracture.

How is it treated without surgery?

Most people heal without an operation.

• Pain relief: appropriate medicines during the most painful weeks
• A brace: it supports the spine and can ease pain while the fracture heals. Wear it if we advise it
• Keep moving: Walk every day and avoid long bed rest. Avoid heavy lifting and bending forward while it heals
• Physiotherapy: once the pain has settled. See the Exercise Programme for Osteoporosis
• Treating the bone: calcium, vitamin D, exercise and, if advised, bone-strengthening medicines. See Osteoporosis

When is a procedure or surgery needed?

A small procedure is considered when:

• Pain stays severe despite proper treatment
• You can't tolerate a brace or lying still
• The fracture is causing a lot of height loss or deformity

Open surgery is uncommon in osteoporosis. It is more likely if a fracture presses on the nerves, makes the spine unstable, or is caused by a tumour or a major injury. If you have been advised surgery and aren't sure, you can send your MRI for a second opinion.

What do vertebroplasty and kyphoplasty involve?

Both are keyhole procedures. Through a small needle, bone cement is placed into the fractured vertebra to steady it, and they often give good pain relief. In kyphoplasty, a small balloon first lifts the collapsed bone, and then the cement is placed. Your surgeon explains which suits you.

What is recovery like?

Most people settle over 6 to 12 weeks. Keep walking and build up activity gradually. The bone-strengthening medicines carry on after the fracture has healed, because they protect you from the next one.

How can I prevent another fracture?

• Treat the osteoporosis with medicine, calcium and vitamin D. See Vitamin D deficiency: what it means for your bones
• Keep active with weight-bearing exercise
• Prevent falls. See Fall prevention in osteoporosis
• Stop smoking and keep alcohol low

Questions to ask your doctor

• Is this fracture from osteoporosis, or could it be something else?
• Do I need a brace, and for how long?
• Do I need a bone scan or blood tests?
• Which medicine should I take to protect my bones?
• Would a procedure help me, and when?

Treatments we offer for this

Pain management, bracing, vertebroplasty and kyphoplasty, treatment planning for osteoporosis, and spinal surgery when a fracture presses on the nerves or makes the spine unstable.

This page is for general information and does not replace a medical consultation. Please see a doctor for advice about your own symptoms.