Low Back & Pelvis

What It Is

Spinal fractures are a serious injury. Most spinal fractures happen in the thoracic (mid-back) and lumbar (lower back) regions, or at the connection between the two (AAOS, n.d.a).

The most common type of fracture linked to osteoporosis (weak bones) is the compression or crush fracture, sometimes known as an anterior wedge fracture (AAOS, n.d.b). These fractures often happen after a fall, but in people with osteoporosis they can happen during everyday activities such as reaching, twisting, coughing or sneezing (AAOS, n.d.b). Osteoporosis is more common in women after the menopause (NHS, 2022).

Spinal fractures can also happen in high-energy accidents, such as a car accident, a fall from a height or a sports accident (AAOS, n.d.a).

People involved in high-energy accidents often have other injuries needing urgent treatment, and the spinal cord and nerves can be injured too (AAOS, n.d.a). Having a spinal fracture does not necessarily mean a spinal cord injury: compression fractures are usually stable and rarely cause nerve problems (AAOS, n.d.a).

Spinal Fracture Anatomy

The spine is made up of small bones called vertebrae, stacked one on top of the other, along with ligaments, nerves, muscles and discs. The vertebrae form a canal that protects the spinal cord. The spine has three main sections: the neck (cervical), the mid-back (thoracic) and the lower back (lumbar) (AAOS, n.d.a).

In a compression fracture, the front of the vertebra cracks and becomes shorter while the back stays intact, creating a classic wedge shape. This is why it is known as an anterior wedge fracture (literally a front wedge fracture). These fractures most often happen near the waistline, around the junction between the upper and lower back (the thoracolumbar junction), although other vertebrae can be affected (AAOS, n.d.a; AAOS, n.d.b).

Risk factors for osteoporosis, and so for this type of fracture, include a family history of osteoporosis, low body weight (a BMI of 19 or less), long-term use of steroid tablets, eating disorders, and heavy drinking and smoking (NHS, 2022).

Problems after Compression Fracture

A spinal bone does not go back to its original shape after a fracture. It heals in its new compressed shape, which can lead to height loss and a change in the shape of your back (Royal Osteoporosis Society, 2022).
Some people have ongoing pain even after the fracture has healed (Royal Osteoporosis Society, 2022).

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

Treatment

Self-Care & Treatment

How to Treat a Spinal Fracture

Gradually increasing activity and doing rehabilitation exercises helps most people avoid problems after the injury (AAOS, n.d.a). Once your medical team is happy, I can guide you through rehabilitation exercises and gentle hands-on care adapted to your back. See the My Approach tab for how I work.

1. Non-Surgical Treatment

Most compression fractures are treated without surgery, and most people feel better within about 3 months (AAOS, n.d.b). A spinal fracture takes 6 to 12 weeks to heal (Royal Osteoporosis Society, 2022). Try to stay as active as possible, as this helps maintain muscle strength and reduces the risk of ongoing pain; if pain is severe early on, rest for a while (Royal Osteoporosis Society, 2022).

2. Pain Relief

The Royal Osteoporosis Society says a pain-relieving medicine can help you stay active (Royal Osteoporosis Society, 2022). (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.)

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

Options outside my scope

Back brace: a brace is sometimes prescribed to support the spine while the fracture heals (AAOS, n.d.b).
Bone density scan and osteoporosis treatment: a scan (DEXA) that measures bone strength, which helps your doctor decide whether you need medicine to reduce the risk of further fractures (AAOS, n.d.b).
Vertebroplasty or kyphoplasty: procedures that inject bone cement into a broken vertebra to ease severe pain that has not improved with pain medicines; they are not suitable for most people (Royal Osteoporosis Society, 2022; AAOS, n.d.b).
Surgery for unstable fractures: some high-energy fractures, such as unstable burst fractures with many bone fragments, severe loss of height, angulation or nerve damage, need an operation to relieve pressure on the spinal cord and fix the bones with screws (AAOS, n.d.a).

How I can help (see the My Approach tab)

Gentle hands-on care for back and muscle pain, adapted for fragile bones
Safe exercises for strength, posture and balance
Advice on staying active and moving safely day to day

Tips

When playing sports, wear the proper sporting equipment to prevent unnecessary injuries.
Take care to avoid high-energy accidents, for example by driving carefully and wearing a seatbelt.
Take all the necessary precautions when climbing or working at height.

Treatment

My Approach

A spinal fracture needs time and protection to heal, and your medical team decides what your back can handle, whether you need a brace, and how quickly to build up. I work inside those limits. If your fracture was treated with surgery, or it stops you doing your normal daily tasks, I need your doctor's or surgeon'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.

I check what you've been cleared for and ask about osteoporosis, then assess your posture, how you move, your strength and balance, and the nerves to your legs.

While It Heals

Gentle, relaxing work for the back, neck and shoulder muscles that tighten and guard, never pressing on the broken bone
Light pressure, with pillows and side-lying or supported positions if your back is rounded
No forceful joint work, rib springing or quick thrusts
Warm applications for tight muscles, and help staying as active as you can, little and often

As It Gets Stronger

Gentle back-strengthening and posture work, such as squeezing the shoulder blades together
Sit-to-stands, heel raises and step-ups, then balance work to help prevent falls
Building up walking and daily activities step by step
Advice on avoiding sit-ups, bending forward under load, and twisting while bending

If back pain after an injury comes with numbness, weakness, or bladder or bowel problems, call 911 (see When to Get Help).

What to Expect

Typical Course

Typical course: Usually visits are once or twice a week early on, then weekly, then spacing out as you manage more on your own, with a reassessment at about 4 to 6 weeks. A spinal fracture usually takes 6 to 12 weeks to heal, and most people feel better within about 3 months, so we follow your medical team's plan.

What I Focus On

Working Within Your Team's Limits

Compensation Relief

Safe Positioning

Back & Posture Strength

Balance & Falls

Please read

When to See a Doctor First

When to Get Help

Call 911 or go to the emergency room at your nearest hospital after any high-energy accident such as a car crash or fall from a height, or if back pain after an injury comes with numbness, tingling or weakness in the arms or legs, or problems controlling your bladder or bowels (AAOS, n.d.a).
See your family doctor or nurse practitioner if you have new back pain that is worse with movement and you have osteoporosis or risk factors for it (AAOS, n.d.b).

Sources

References

American Academy of Orthopaedic Surgeons (n.d.a) Fractures of the thoracic and lumbar spine. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/fractures-of-the-thoracic-and-lumbar-spine/ (Accessed: 7 October 2026).
American Academy of Orthopaedic Surgeons (n.d.b) Osteoporosis and spinal fractures. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/osteoporosis-and-spinal-fractures/ (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).
NHS (2022) Osteoporosis – causes. Available at: https://www.nhs.uk/conditions/osteoporosis/causes/ (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooSpinal Fracture

What It Is

Spinal Fracture Anatomy

Problems after Compression Fracture

Self-Care & Treatment

How to Treat a Spinal Fracture

1. Non-Surgical Treatment

2. Pain Relief

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

Tips

My Approach

While It Heals

As It Gets Stronger

Typical Course

When to See a Doctor First

When to Get Help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooSpinal Fracture

What It Is

Spinal Fracture Anatomy

Problems after Compression Fracture

Self-Care & Treatment

How to Treat a Spinal Fracture

1. Non-Surgical Treatment

2. Pain Relief

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

Tips

My Approach

While It Heals

As It Gets Stronger

Typical Course

When to See a Doctor First

When to Get Help

References

Related Conditions

Ankylosing Spondylitis (AS)

Cervical Spondylotic Myelopathy

Coccydynia

Coccyx Fracture

Book a session