Soft, weakened bones are at the heart of this problem. Compression fractures are often caused by bone-thinning osteoporosis, especially if you are a woman over age 50.
When bones are brittle, everyday activities can trigger minor spinal compression fractures. When you bend to lift an object, miss a step, slip on a carpet, for instance, you can put your spinal bones at risk of fracture. Even coughing or sneezing can cause compression fractures in more severe cases of osteoporosis.
After a number of small compression fractures, your body begins to show the effects. The small hairline fractures can eventually cause a vertebra to collapse - called spinal compression fracture.
These fractures can permanently alter the strength and shape of the spine. You lose height because your spine is shorter. Most compression fractures occur in the front of the vertebra, which causes the front part of the bone to collapse - creating a wedge-shaped vertebra, because the back of the bone is unchanged. This creates the stooped posture called kyphosis, or dowager's hump.
About two-thirds of spinal compression fractures are never diagnosed because many patients and families think the back pain is merely a sign of aging and arthritis. In fact, many people put off seeing a doctor because they don't realize what's wrong, says Rex Marco, MD, chief of spine surgery and musculoskeletal oncology at the University of Texas Health Science Center at Houston.
"They have pain, but they don't realize what they have is a spinal fracture," he tells WebMD. "And if their osteoporosis doesn't get treated, it can lead to future fractures -- and possibly more severe compression fractures." Osteoporosis treatment significantly reduces but does not eliminate the chance of developing another compression fracture.
Each spinal compression fracture can cause increased lung and breathing problems and even early death, Marco says. "If the fracture doesn't heal, the patient gets depressed because they're in pain. They keep taking pain medication, get constipated, get more depressed. They often have more fractures, and sometimes they get put in a nursing home. It's a terrible problem."
Who Is at Highest Risk?
Two groups of people are at highest risk for compression fractures:
- People with the bone-weakening disease osteoporosis.
- People with cancer that has spread to their bones.
If you have been diagnosed with certain kinds of cancer -- including multiple myeloma and lymphoma -- your doctor may monitor you for compression fractures. However, "sometimes a spinal fracture is the first indication of cancer," Marco says.
But if you have osteoporosis, you may not even know it.
Here are the leading risk factors for osteoporosis:
- Race: White and Asian women have the greatest risk.
- Age: The risk rises rapidly in women over 50 and increases with age.
- Weight: Thin women are at higher risk.
- Early Menopause: Women who went through menopause before age 50
- Smokers: People who smoke lose bone thickness faster than nonsmokers
Statistically, among people over age 50, osteoporosis strikes:
- 20% of white and Asian women
- 10% of Hispanic women
- 5% of black women
- 5% of men
And among those who develop compression fractures, studies indicate they face a 23% increase in mortality.
"Frequently we see older ladies who lift something 15 to 20 pounds - heavy enough to cause a compression fracture that sends them to a nursing home," Schaufele tells WebMD. "If she has significant underlying osteoporosis, it can cause a significant fracture. The pain is the biggest issue. And if she is not active enough, she can develop pneumonia."
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