When is back pain a spinal fracture?
Diagnosing spinal fractures

Spinal fractures due to osteoporosis often occur while doing something that causes relatively minor trauma to the spine, such as an insignificant fall, or twisting while lifting, or opening a window. Advanced cases of osteoporosis can even lead to a vertebral fracture with routine activities that would normally not cause any trauma, such as sneezing, coughing or turning over in bed.
Occurring in approximately 750,000 people in the U.S. each year, spinal fractures that occur as a result of osteoporosis are actually quite common. However, spinal fracture is not always diagnosed. Often spinal fractures are dismissed as general back pain, such as from a muscle strain or other soft tissue injury, or as a common part of aging. Approximately two thirds of the vertebral fractures that occur each year are not diagnosed and therefore not treated.
A combination of problems from vertebral fractures can lead to changes in the individual’s self-image, which in turn can adversely affect self esteem and ability to carry on the activities of daily living. Vertebral fractures are usually followed by acute back pain, and may lead to chronic pain, loss of height, crowding of internal organs, deformity (thoracic kyphosis, commonly referred to as a dowager's hump), and loss of muscle and aerobic conditioning due to lack of activities and exercise.
It’s important to remember that fractures from osteoporosis don’t just occur in the elderly. Spinal fractures can also occur in people as young as 40 or 50 years old. Because osteoporosis does not show any symptoms until the first break or fracture, it is not uncommon for someone with back pain to be unaware of the fact that she has actually fractured a vertebra (or multiple vertebrae) in her spine.
Symptoms of a spinal fracture
The main clinical symptoms of vertebral fractures typically include one or a combination of symptoms which include a sudden onset of back pain, standing or walking will usually make the pain worse, lying on one’s back makes the pain less intense, limited spinal mobility, height loss, and deformity and disability
A compression fracture as a general rule should be suspected in any patient over the age of 50 with acute onset of back pain. For women with risk factors for osteoporosis, many physicians believe that a vertebral fracture should be suspected in any women over age 45 with sudden onset of back pain. In addition, sometimes a compression fracture in the spine may not cause any back pain or other symptoms. This means that even if there is not back pain, middle age or elderly persons (especially women) need to be concerned about potential fractures if there is , limited ability to twist and bend the back, height loss, and/or deformity that develops in the spine.