The lower back or lumbar spine is made of a stack of 5 block-like bones called vertebrae with a triangular bone attached underneath.The tip of the triangular bone is the tailbone, or coccyx. If the bones of the spine are not strong enough to support normal daily activities or minor stress, such as a minor fall or stumble, they may partially collapse. If this occurs, the condition called osteoporosis is present. It is due to bones with abnormal content and structure of the calcium in the bones. Although technically called a ‘fracture’, an osteoporotic compression fracture is better thought of as a collapse of part of a vertebra.
Compression fractures may occur silently, and are noticed by chance when x-rays are taken for other reasons. However often the pain may be extremely severe, especially with any movement such as bending or standing. The pain is usually described as sharp, catching or knife-like pain and is very intense. It usually will be relieved by lying down. Severe compression fractures may rarely cause compression on the spinal cord or nerves causing pain in the buttocks or legs.
X-rays of the lumbar spine will diagnose an osteoporotic compression fracture most of the time. Difficulties arise when there is more than one fracture, or a new fracture. Sometimes an old partial collapse will worsen. MRI or nuclear bone scans can help to understand if a compressed vertebra is old or new.
Treatment is determined by the severity of the pain. Pain may improve more quickly in certain situations by injecting a special bone cement into the fractured vertebra. This is called a vertebroplasty or kyphoplasty.
Along with treatment of the pain, your doctor may recommend one of several osteoporosis medications to reduce the future chance of another fracture. These may include one of the following medications; Actonel, Atelvia, Boniva, Evista, Forteo, Fosamax, Prolia, Protelos (or Protos), Reclast and Zometa. These medications have been shown to reduce spine and often hip fractures. They all have certain precautions, risks and side effects which should be fully explained by your health provider and pharmacist. Calcium and vitamin D supplements are generally recommended as well as routine weight bearing exercise once the fracture has healed.