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Physical Therapy for Vertebral Compression Fractures

What are Vertebral Compression Fractures?
Vertebral compression fractures are extremely common in patients with compromised bone density, as in the case of osteoporosis or osteopenia. In patients without compressed bone density, typically extreme vertical trauma is involved. About 1.5 million fractures occur annually due to osteoporosis, with half of these fractures occurring at the spine.   

How are Vertebral Compression Fractures diagnosed?
The gold standard for diagnosing compression fractures is through imaging, such as an X-ray or MRI. In lateral view X-rays, compression fractures are characterized as a wedge deformity, with a loss of vertebral height that is greater in the front of the vertebra.

Symptoms of a Vertebral Compression Fracture include:

  • History of major trauma, such as a car accident, fall from an elevated surface, or direct blow to the spine
  • Older age
  • Prolonged use of corticosteroids
  • Point tenderness over the site of fracture
  • Increased pain with weight bearing

How can Physical Therapy help after a Vertebral Compression Fracture?
Some patients with neurological deficits or complications may be recommended surgery by their Physician. The two most common surgeries are a kyphoplasty and vertebroplasty, which involve injecting cement into the bone. 

Physical Therapy treatments include:

  • Manual therapy to reduce pain
  • Dry needling to reduce pain
  • Exercise to promote improved posture and stand fully erect
  • Strengthening exercises to muscles around the compression fracture
  • Osteoporosis management strategies to lessen risks of future compression fractures


  1. Delitto, Anthony, et al. “Low Back Pain.” Journal of Orthopaedic & Sports Physical Therapy, vol. 42, no. 4, 2012, https://doi.org/10.2519/jospt.2012.42.4.a1
  2. Hwang, Michael, et al. “Postoperative Physical Therapy Following Balloon Kyphoplasty for Management of Vertebral Burst Fracture: A Case Report.” JOSPT Cases, Vol. 3, No. 1, 15 Feb. 2023, https://doi.org/https://doi.org/10.2519/josptcases.2022.11399
  3. “Osteoporosis and Kyphoplasty.” University of Maryland Medical Center, https://www.umms.org/ummc/health-services/orthopedics/services/spine/patient-guides/osteoporosis-kyphoplasty#:~:text=Approximately%20half%20of%20these%20fractures,the%20first%20increases%20five%2Dfold
  4. Ross, Michael D., and Ryan L. Elliott. “Thoracic Spine Compression Fracture in a Patient with Back Pain.” Journal of Orthopaedic & Sports Physical Therapy, Vol. 38, No. 4, 2008, pp. 214–214., https://doi.org/10.2519/jospt.2008.0404

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