Whole body

What It Is

Anterior wedge fractures are fractures that occur when a vertebra (one of the bones of the spine) breaks and collapses. The most common cause is osteoporosis, a condition in which the bones become thin and fragile, but they can also be caused by trauma to the back and by cancer, either spreading to the bone from elsewhere or starting in the spine, such as multiple myeloma (MedlinePlus, 2025). Symptoms usually include back pain, which can come on suddenly and be severe, although some fractures cause no symptoms at first. In rare cases they can cause numbness, tingling, weakness, difficulty walking or loss of control of the bladder or bowel (MedlinePlus, 2025).

By far the biggest cause of wedge fractures is osteoporosis (MedlinePlus, 2025). If the spine is osteoporotic, the bone is thinner and even small traumas or falls can cause a collapse. In fact, the fracture is often the first sign that a person has weak bones (AAOS, n.d.). The collapse can even happen during everyday activities such as reaching, twisting, coughing or sneezing, so some people have no memory of a fall or injury (AAOS, n.d.).

These fractures often happen after a fall (AAOS, n.d.). The most common place for spinal fractures is the level between the upper and lower back, known as the thoracolumbar junction, around the T12 and L1 vertebrae and the vertebrae next to them, such as T11 (Ghadiyaram et al., 2024). This is roughly at the level of the waistline (AAOS, n.d.).

Anterior wedge fractures are often called vertebral crush or vertebral compression fractures.

Your doctor can use several different tests to confirm whether you have one of these fractures.

Anterior Wedge Fracture Anatomy

Bones in the spine are known as vertebrae (plural); there are 24 of them, stacked one on top of each other (AAOS, n.d.). They are joined by facet joints and by the discs that sit in between each vertebra. Spinal nerves leave the spinal cord at each level through openings between the vertebrae, known as foramina.

When the vertebra crushes or collapses, it tends to collapse at the front while the back stays intact (AAOS, n.d.). This is why compression fractures are sometimes known as anterior wedge fractures. As the bone at the front of the vertebra collapses, it forms a wedge shape. The severity of the fracture affects how much wedging occurs. Also, if there is underlying weakness in the bone, for example from osteoporosis, the wedging is likely to be more pronounced.

In a younger person without osteoporosis, the trauma would need to be significant, such as a bad fall or a car accident, to have enough force to fracture the vertebra.

How to Diagnose an Anterior Wedge Fracture to the Spine

Diagnosis is not always easy and it's possible for these fractures to be missed. Some cause no symptoms at first and are only found on X-rays taken for another reason (MedlinePlus, 2025). In some cases the history alone strongly suggests a fracture, for example if a person known to have osteoporosis has had a fall. However, in many cases the pain can seem like other problems in the spine. Your doctor will examine your spine and posture, press on parts of your back to find where the pain is coming from, and check your nerves for numbness, reflex changes or weak muscles (AAOS, n.d.).

An X-ray is usually used to look for a compression fracture. An MRI scan can show whether the fracture is new, and a CT scan can show whether the fracture has spread into the spinal canal. Your doctor may also check for osteoporosis with a bone density scan, called a DEXA scan (AAOS, n.d.).

Problems Following an Anterior Wedge Fracture of the Spine

In the early days there will be pain around the injury site. It often gets worse when you move, especially when changing position, and resting or lying down often helps (AAOS, n.d.). Many people recover well: a spinal fracture usually takes between 6 and 12 weeks to heal (Royal Osteoporosis Society, 2022), and most people feel better within 3 months without surgery (AAOS, n.d.).

The broken bone heals in its new, compressed shape, which can lead to some loss of height and a change in body shape (Royal Osteoporosis Society, 2022). For some people, pain continues after the fracture has healed. This is caused by the change in the shape of the spine, which can strain the joints, ligaments and muscles of the back, irritate nerves, or make existing arthritis worse (Royal Osteoporosis Society, 2022). If you still have pain after three months, there are things that can help you manage it, so talk to me or your family doctor or nurse practitioner.

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Anterior Wedge Fractures

Physical therapy can improve movement and strength around the spine (MedlinePlus, 2025), and gentle general exercises can ease tension and muscle spasms in your back, with strength work once the fracture has healed (Royal Osteoporosis Society, 2022). Within your medical team's limits, I can support this with gentle hands-on work and suitable exercises. See the My Approach tab for how I work.

1. Pain Relief

The Royal Osteoporosis Society (2022) suggests that, when you are ready, taking a pain-relieving medicine can help you stay active. Medication won't help the fracture heal, but it can help you deal with the pain. Ask your pharmacist or your family doctor or nurse practitioner which pain relief is suitable for you. (This medicine information comes from the Royal Osteoporosis Society, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

2. Staying Active

It is recommended that you aim to stay as active as possible. This can reduce the risk of chest infections, constipation, blood clots and other side effects, helps you keep your muscle strength, and reduces your chances of ongoing pain after the fracture has healed. Movement does not affect the healing process. If your pain is severe in the early stages, rest for a while (Royal Osteoporosis Society, 2022). Modify your activities according to your own pain level, and avoid lifting anything heavy or anything that puts too much strain on the fractured area. Treat the fracture seriously and carefully.

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Osteoporosis assessment and treatment: after a spinal fracture your doctor may check your bone strength with a DEXA scan and discuss medicines and calcium supplements to help prevent further fractures (AAOS, n.d.; MedlinePlus, 2025). This matters because more than 30% of people with a spinal fracture have another fracture within 1 year (AAOS, n.d.).
Calcitonin: a medicine that is sometimes used to help relieve bone pain (MedlinePlus, 2025).
Back brace: sometimes a brace is worn while the fracture heals (AAOS, n.d.). Research suggests a brace may reduce pain for a few months but does not improve posture or everyday function (Squires et al., 2023), and MedlinePlus (2025) notes that braces may further weaken the bones. A brace should only be used if your medical team advises and fits it.
Kyphoplasty and vertebroplasty: procedures in which bone cement is injected into the broken vertebra to stabilise it; in kyphoplasty, a small balloon is first inflated inside the bone to make space. They can be done under a general or a local anaesthetic, are only suitable for some people whose severe pain has not been helped by pain-relieving medicines, and do not strengthen the bones or reduce the risk of breaking another bone (Royal Osteoporosis Society, 2022; AAOS, n.d.).
Other surgery: rarely, other spinal surgery may be needed, for example if the fracture is caused by a tumour (MedlinePlus, 2025).

How I can help (see the My Approach tab)

Gentle hands-on work for tight, sore back muscles
Exercises to keep you moving, then rebuild strength once the bone has healed
Advice on moving and lifting safely day to day

Tips

Osteoporosis is the most common cause of compression fractures. Try to look after your bone health with a good, nutritious balanced diet with enough calcium, and regular load-bearing exercise such as walking, which can help you avoid bone loss (MedlinePlus, 2025).
Trauma to the spine can cause minor or severe fractures.
Cancer can weaken the bones to the point where they collapse.
When lifting an item, make sure to lift with your legs and not with your back.
Many people recover well, but some have ongoing pain or stiffness after a wedge fracture (Royal Osteoporosis Society, 2022). If this happens to you, ask me or your family doctor or nurse practitioner about ways to manage it.

Treatment

My Approach

After a spinal fracture, the bone needs time to heal, and your medical team decides how much you can do and whether you need a brace. I work inside those limits. If your fracture was treated with surgery, stops you doing your normal daily activities, or is linked to cancer and its treatment, I need your medical team's okay before any hands-on treatment.

Please bring any X-ray or scan reports and notes from your medical team to your first visit. They're an important part of planning safe treatment for you.

While It Heals

Gentle massage for the back, neck and shoulder muscles that tighten up around the fracture, with no pressure over the broken bone
Setting you up comfortably with plenty of pillows, especially if your upper back has become more rounded
Breathing and relaxation, and gentle movement of the joints that aren't involved
Help staying as active as your pain allows, including getting in and out of bed or a chair without straining your spine

Once It Has Healed

Gentle work around the scar if you had a procedure or surgery, once it has healed and your team is happy
Building up strength in your back muscles, plus sit-to-stands, heel raises and gentle shoulder blade squeezes
Walking and other weight-bearing activity, built up gradually, with balance work to help prevent falls
Lifting with your legs, and avoiding sit-ups, bending forward against resistance and twisting while bending

With fragile bones, I avoid anything that puts force through them, such as springing the ribs, forceful joint work or pressing joints hard at the end of their range. If you get new numbness, tingling or weakness in your legs, difficulty walking, or loss of bladder or bowel control, call 911 or go to the emergency room.

What to Expect

Typical Course

Typical course: While the bone heals, most people come about once a week for shorter, gentle sessions, then weekly or every two weeks for strength and balance work once your medical team confirms it has healed, spacing out as you manage more on your own. A spinal fracture usually takes 6 to 12 weeks to heal and most people feel better within about 3 months, with your medical team guiding how quickly you build up.

What I Focus On

Working Within Your Team's Limits

Safe Positioning

Compensation Relief

Staying Active

Back Strength & Balance

Please read

When to See a Doctor First

When to Get Urgent Help

Call 911 or go to the emergency room at your nearest hospital if you have back pain together with new numbness, tingling or weakness in your legs, difficulty walking, or loss of control of your bladder or bowel. In rare cases these can mean the spinal cord or nerves are being squashed (MedlinePlus, 2025).

Sources

References

American Academy of Orthopaedic Surgeons (n.d.) Osteoporosis and spinal fractures. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/osteoporosis-and-spinal-fractures/ (Accessed: 7 October 2026).
MedlinePlus (2025) Compression fractures of the back. Available at: https://medlineplus.gov/ency/article/000443.htm (Accessed: 7 October 2026).
Royal Osteoporosis Society (2022) Spinal fractures (vertebral fractures). Available at: https://theros.org.uk/information-and-support/living-with-osteoporosis-and-broken-bones/spinal-fractures-vertebral-fractures/ (Accessed: 7 October 2026).
Squires, M., Green, J.H., Patel, R. and Aleem, I. (2023) 'Clinical outcomes after bracing for vertebral compression fractures: a systematic review and meta-analysis of randomized trials', Journal of Spine Surgery, 9(2), pp. 139-148. doi: 10.21037/jss-22-78
Ghadiyaram, A. et al. (2024) 'A4 thoracolumbar fracture class is associated with a greater degree of vertebral height loss in conservatively managed patients', Cureus, 16(8), e66402. doi: 10.7759/cureus.66402

Massage therapy · Kitchener–WaterlooAnterior Wedge Fracture to the Vertebra

What It Is

Anterior Wedge Fracture Anatomy

How to Diagnose an Anterior Wedge Fracture to the Spine

Problems Following an Anterior Wedge Fracture of the Spine

Self-Care & Treatment

How to Treat Anterior Wedge Fractures

1. Pain Relief

2. Staying Active

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

While It Heals

Once It Has Healed

Typical Course

When to See a Doctor First

When to Get Urgent Help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooAnterior Wedge Fracture to the Vertebra

What It Is

Anterior Wedge Fracture Anatomy

How to Diagnose an Anterior Wedge Fracture to the Spine

Problems Following an Anterior Wedge Fracture of the Spine

Self-Care & Treatment

How to Treat Anterior Wedge Fractures

1. Pain Relief

2. Staying Active

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

While It Heals

Once It Has Healed

Typical Course

When to See a Doctor First

When to Get Urgent Help

References

Related Conditions

Vertebral Crush / Compression Fracture

Amyotrophic Lateral Sclerosis

Bone Tumor

Chronic Fatigue Syndrome

Book a session