Broken back: Symptoms, treatment, and recovery

Scientists divide the spine into three parts:

• the cervical spine runs from the base of the brain to the top of the shoulders
• the thoracic spine is the mid-back
• the lumbar spine is the lower back

When someone has a broken back, it means that one or more of these interconnecting bones has fractured or broken. Most spinal fractures occur in the thoracic or lumbar spine.

Doctors may divide spinal fractures into mechanism types, such as flexion, extension, and rotation. However, not all spinal fractures fit neatly into each subdivision.

Generally, the types of fractures include:

Flexion fracture

The main types of flexion fractures are:

• Compression fractures: These happen when the front of the vertebra breaks and loses height, but the back of the vertebra remains intact. The bones do not usually move out of place. Compression fractures are common in people who have health conditions that weaken the bone, such as osteoporosis or cancer.
• Axial burst fractures: These occur when the vertebra loses height at the front and back. Such fractures commonly occur when someone lands on their feet after falling from a height. Burst fractures can also cause spinal fragments to enter the spinal canal.

Extension fracture

Doctors may also call these distraction fractures. It means the vertebrae have pulled apart. Head-on automobile collisions are the most common cause of extension fractures.

Rotation fracture

There are two types of rotation fracture:

• Transverse process fracture: This type of fracture is relatively common. It happens when the spine rotates or bends sideways. These fractures are not always serious.
• Fracture-dislocation: This describes a spine that has sustained both a fracture and a dislocation. It makes the stack of vertebrae that make up the spine unstable. Often, this kind of spinal fracture can cause problems with the nerves by crushing the spinal cord. Sometimes, these injuries are severe, but surgery is not always necessary.

The most common cause of a broken back is trauma, such as:

• an automobile accident
• a fall from a significant height
• a sporting accident
• a violent act, such as a severe assault or gunshot wound

People with health conditions that weaken the bones, such as osteoporosis, tumors, or cancer, are susceptible to spinal fractures. It means that even strenuous reaching or twisting can result in a broken back.

A broken back will hurt. The pain in the back will come on suddenly and get worse when the person moves. The pain might be moderate or severe.

Sometimes, a spinal fracture can also damage the spinal cord. This can lead to a variety of outcomes, which may include bladder or bowel dysfunction. They may also experience numbness, tingling, or weakness in the limbs.

A doctor will diagnose a broken back after performing a physical examination and conducting imaging tests.

During the physical exam, the doctor will examine the person from head to toe, including the head, abdomen, pelvis, limbs, and spine.

The doctor will make the final diagnosis based on the results of imaging tests. These might include X–rays, CT scans, and MRI scans.

Treatment will depend on the severity of the spinal fracture. In most cases, doctors will recommend the person wear a back brace. This will keep the spine supported while the vertebrae heal.

Healing can take 6–12 weeks. Usually, the person will also need to follow an individualized exercise program designed to help them build up their activity and motion slowly.

The person may need surgery if the break is severe or if it has damaged the nerves.

Surgery aims to put the bones back into their original position and relieve pressure on the nerves or spinal cord. A surgeon will use metal screws, rods, or cages to stabilize the spine.

Spinal fractures that do not require surgery can take 6–12 weeks to heal. Recovery after back surgery can take longer.

During the recovery period, a person may need to wear a back brace and follow an exercise program. A doctor or physiotherapist will usually recommend a range of exercises designed to help the person build up their activity levels over time.

The UK’s Royal Osteoporosis Society recommend some exercises to people experiencing pain as a result of spinal fractures. However, person with a broken back should only exercise if their doctor has given express approval.

Doctors can usually treat spinal fractures without the need for an operation. They tend to take 6–12 weeks to heal.

People with underlying health conditions that weaken the bones, such as osteoporosis and cancer, may be at risk of repeated spinal fractures.