Low Back & Pelvis

What It Is

A transverse process fracture is a break in one of the small bony projections on the side of a vertebra. On its own it does not usually affect the stability of the spine and does not need surgery (AAOS, n.d.). They can occur in any vertebra, but the middle and lower back are common areas. However, these fractures are often caused by high-energy accidents, such as falling from a height or a car accident, and can come with other serious injuries, including injuries to organs in the abdomen, which doctors need to rule out (Agrawal, Srivastava and Kakani, 2009; Kaya, 2024).

Older people whose bones are weakened by osteoporosis can fracture a vertebra in lower-impact events (AAOS, n.d.).

Transverse process fractures result from rotation or extreme sideways bending (AAOS, n.d.).

Many people call the fracture a "broken back" or "fractured vertebra", which technically it is, as part of the vertebra has broken. However, an isolated transverse process fracture does not involve the spinal cord, so it is very unlikely to cause nerve problems. If the trauma is large enough and other vertebrae are also fractured or dislocated, spinal cord injury is possible.

Transverse Process Fracture Anatomy

The spine is made up of 33 small bones, called vertebrae, stacked on top of each other (AAOS, n.d.). Ligaments, nerves, muscles and intervertebral discs are also part of the spine.

The vertebrae form a canal that protects the spinal cord. The spine has three main sections that create its natural curves: the neck (cervical), the chest area or mid-back (thoracic) and the lower back (lumbar).

Spinal nerves branch out from the spinal cord through openings between the vertebrae to carry messages between the brain and the muscles.

The transverse process is a projection of bone on the side of the vertebra; there is one on each side. The projection at the back of the vertebra is called the spinous process.

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

Treatment

Self-Care & Treatment

How a Transverse Process Fracture Is Treated

These fractures are usually treated with a gradual increase in movement, with or without a brace for comfort (AAOS, n.d.). I can guide you through this with gentle hands-on work and a graded exercise programme, within your medical team's plan. See the My Approach tab for how I work.

One study found a rigid lumbar corset did not improve pain (Kaya, 2024). Gradually increasing activity and doing rehabilitation exercises helps most people recover well.

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

Options outside my scope

Brace: your doctor may suggest one for comfort, but it is not always needed (AAOS, n.d.).
Surgery: isolated transverse process fractures do not usually need surgery; surgery is used for other, more serious spinal fractures, such as unstable fractures or those pressing on the spinal cord (AAOS, n.d.).

How I can help (see the My Approach tab)

Gentle hands-on work for tight, guarding back muscles

A graded exercise programme to rebuild movement and strength

A gradual return to work, sport and the gym

Tips

Whether or not you have surgery, you will need a period of rehabilitation after the injury has healed (AAOS, n.d.).
Rehabilitation helps reduce pain, regain movement and return you as closely as possible to how you were before the injury.
Follow your medical team's advice and the home programme I give you to improve your recovery.

Treatment

My Approach

These fractures often come from a big accident, so your hospital team needs to check you for other injuries first. Your medical team then decides whether you need a brace and how quickly you build up your activity, and I work within their plan. If you've had surgery, or your injuries stop you managing your normal daily tasks, I need their okay before 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 muscles that tighten to guard the area, with no pressure over the broken bone
Easing the neck, shoulders and hips, which take extra strain
Warm or cool applications in the clinic, and safe use of heat or ice at home
Breathing and relaxation, and gentle, pain-free movement and walking, built up day by day
No twisting or side-bending stretches into pain while the bone heals

As You Get Stronger

Gentle mobilisation of stiff joints in the spine, never quick or forceful, and not at the injured level until your team confirms it has healed
Trunk and hip strength, from gentle holds and bridges to hip hinges, carries and gym-based lifting
A home programme, and a graded return to work, sport and the gym

If your bones are weakened by osteoporosis, I keep the pressure light. If you get numbness, tingling or weakness in your arms or legs, or problems controlling your bladder or bowels, call 911 or go to the emergency room (see When to get emergency help).

What to Expect

Typical Course

Typical course: Most people come once or twice a week at first, then weekly, with a reassessment at about 4 to 6 weeks, then less often, all fitted around your medical team's plan. The bone usually heals over about 6 to 8 weeks, and full activity follows a little later, at the pace your team advises.

What I Focus On

Working Within Your Team's Plan

Guarding Muscle Relief

Gentle Movement

Trunk & Hip Strength

Graded Return to Activity

Please read

When to See a Doctor First

When to get emergency help

Anyone with a back injury after a high-energy accident needs emergency assessment (AAOS, n.d.). call 911 or go to the emergency room at your nearest hospital if you have severe back pain that gets worse with movement after an injury, or problems controlling your bladder or bowels, or numbness, tingling or weakness in your arms or legs (AAOS, n.d.).

Sources

References

American Academy of Orthopaedic Surgeons (n.d.) 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).
Agrawal, A., Srivastava, S. and Kakani, A. (2009) 'Isolated transverse process fracture of the lumbar vertebrae', Journal of Emergencies, Trauma, and Shock, 2(3), pp. 217–218. doi: 10.4103/0974-2700.55350
Kaya, M. (2024) 'Isolated transverse process fractures: should we offer lumbar corset or not?', Cureus, 16(4), e57700. doi: 10.7759/cureus.57700

Massage therapy · Kitchener–WaterlooTransverse Process Fracture

What It Is

Transverse Process Fracture Anatomy

Self-Care & Treatment

How a Transverse Process Fracture Is Treated

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

Tips

My Approach

While It Heals

As You Get Stronger

Typical Course

When to See a Doctor First

When to get emergency help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooTransverse Process Fracture

What It Is

Transverse Process Fracture Anatomy

Self-Care & Treatment

How a Transverse Process Fracture Is Treated

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

Tips

My Approach

While It Heals

As You Get Stronger

Typical Course

When to See a Doctor First

When to get emergency help

References

Related Conditions

Ankylosing Spondylitis (AS)

Cervical Spondylotic Myelopathy

Coccydynia

Coccyx Fracture

Book a session