What Is a Wedge / Compression Fracture?
A wedge fracture is a type of compression fracture where part of the vertebrae—usually at the front (anterior) side of the body—fractures and collapses while the back side stays intact, resulting in a wedge-shaped vertebra. If you have several of these wedge breaks, your back may begin to curve forward into a hunchback position known as kyphosis.
Trauma in one shape or form is to blame for any compression fracture. For someone with osteoporosis, this force might be pretty minimal, like sneezing, getting out of the tub or lifting something heavy. But for someone with healthy bones, quite a bit more trauma (think a car accident or a fall off a trampoline) paired with a forward bend is needed to cause such fractures.
Anterior wedge compression fractures are most common at the bottom of the thoracic spine, specifically the T11 or T12 vertebrae or at L1 vertebra at the top of the lumbar spine.
In most cases, these are stable fractures, meaning the bone is unlikely to continue to crumble and cause more problems—at least immediately. This means that surgery is not a common mode of wedge fracture treatment. And while neurological impairment does occur, it is pretty rare.
While someone with osteoporosis may not even realize they have one or several osteoporotic wedge fractures, the symptoms are much more obvious for those in an athletic or automobile accident—the intense pain is a symptom that’s pretty hard to miss.
Spinal injuries are nothing to mess around with and you should seek immediate medical help if you suspect you’ve damaged the spine, especially if you experience signs of neurological damage like numbness or tingling.
Are You At Risk of a Wedge Fracture?Some of the things that put you at risk of a thoracic or lumbar wedge fracture are things that you simply cannot control. For instance, your risk goes up if you are/have:
- Over the age of 50
- Caucasian, Asian, Hispanic/Latino or African American
- A family history of wedge fractures
- Broken bones in the past
- Certain cancers
- Are thin or overweight
- Don’t get enough vitamin D or calcium
- Are inactive
- Are involved in certain high-risk sports
Extreme Sports and Spinal Wedge Fractures
Basically, you have to think of sports where a misstep or accident can lead to a combination of a lot of force and a forward bend. One of the examples I came across, again and again, was horseback riding—specifically jumping or cross country events. The list also includes:
- Rodeo events (e.g., bull riding)
- Equestrian sports
- Alpine skiing
- Paragliding, skydiving, base jumping, etc.
- Mountain biking
What Can You Do to Prevent a Wedge Fracture of the Spine?Enthusiasts for many of these sports are well aware that they involve risks to the spine (and other areas of the body) and avoiding them is simply not going to happen. But there are some common-sense steps you can take to limit your risk of a wedge break in your back. These include things like:
- Using proper safety equipment (helmets, knee and elbow pads, lower back braces, etc.)
- Following general safety guidelines
- Respecting your abilities and limits
- Being aware of your surroundings and avoiding risky surfaces
- Using your legs to lift, with your core engaged and the spine neutral; a lifting belt can also help
- Fixing or maintaining good posture (a forward-craned neck can up your risk of a cervical wedge fracture)
The Damage Is Done, Now What?
Message board threads on wedge fractures of the spine are filled with users’ questions about how soon they can get back in the saddle, hit the slopes or get back to deadlifting. These are also a good place for cautionary stories about what can happen if you don’t give your body the time it needs to heal.
There is no magic number regarding how long it will take to bounce back from wedge fracture in the spine. This will depend on the health and age of the individual, whether there are any coinciding injuries (usually the case with extreme sports injuries), the degree of compression, whether surgery is needed, etc. But generally speaking, you will likely be talking about a recovery period that stretches weeks or months.
You will likely need to wear a special back brace to keep your spine upright and limit your ability to twist of flex for a period, protecting against further damage and limiting stress on the spine as it heals. For some other options, check out our full selection of back braces for compression fractures.
Other treatment steps will likely include activity modification (especially a break from any jarring or strenuous movements), ice/heat therapy and physical therapy to reduce pain and inflammation, improve strength and flexibility, and to lower your risk of injury down the road.
In some cases, you may need an injection of spinal cement into the wedged vertebrae to restore its height. Or in rare cases, surgery may be needed to immobilize the bone via surgical hardware.
Whether or not your cervical, thoracic or lumbar wedge fracture requires surgery to repair, you will need time and patience to make a successful recovery and get back to doing the things you love.