Glossary · Term
Vertebral fracture
In weakened bones, a vertebra can squash down on itself with little or no injury. Many of these fractures are never diagnosed, and one makes another more likely.
A vertebral fracture is a break in one of the bones of the spine. When bone has been weakened by osteoporosis, it is usually a compression fracture: the vertebra squashes down on itself rather than breaking apart (Royal Osteoporosis Society). A spinal fracture takes 6 to 12 weeks to heal, and the bone heals in its new, compressed shape, which is why several fractures can lead to height loss and a change in body shape (Royal Osteoporosis Society).
What are the signs of a vertebral fracture?
Possible signs are unexplained back pain and muscle spasms, height loss, and a curved spine or a change in posture. They become more noticeable the more fractures someone has. Some spinal fractures don’t cause the pain you would expect from a broken bone, and the pain can be mistaken for something else, such as arthritis (Royal Osteoporosis Society). The NHS describes the same picture: back pain, a hunched posture and getting shorter can all be caused by small breaks in the bones of the spine (NHS).
A rounded upper back has many other causes, from habit to the normal shape of the spine; see thoracic kyphosis and rounded upper back.
Why so many go unnoticed
In 6,084 older women who had spine X-rays at the start and end of a treatment trial, only about a quarter of the new vertebral deformities seen on the X-rays had been diagnosed as fractures by their own doctors (Fink et al., 2005).
Even when an X-ray is taken, a fracture can be missed. In 2,451 postmenopausal women with osteoporosis, 32% had at least one vertebral fracture. Comparing local X-ray reports with expert central readings gave a false-negative rate of 34%, partly because fractures weren’t spotted and partly because reports used ambiguous wording (Delmas et al., 2005).
Why one fracture matters
A vertebral fracture is a strong signal that another may follow. Pooling earlier studies, women with an existing vertebral fracture had about four times the risk of a new one (Klotzbuecher et al., 2000). In 2,725 postmenopausal women from the placebo groups of four osteoporosis trials, having a vertebral fracture at the start went with five times the risk of a new one within the first year (Lindsay et al., 2001).
That is why a suspected fracture is worth taking to a GP. If spinal fractures are found, a doctor may prescribe osteoporosis medication straight away or arrange a bone density scan first (Royal Osteoporosis Society).
Living and working with a vertebral fracture
Most people don’t need an operation. The Royal Osteoporosis Society recommends staying as active as possible: movement doesn’t affect healing, and it helps maintain muscle strength and lowers the chance of ongoing pain (Royal Osteoporosis Society). Fractures caused by osteoporosis are stable and do not cause paralysis (Royal Osteoporosis Society).
A UK consensus statement recommends that people with osteoporosis avoid postures with a high degree of spinal flexion, during exercise or daily life, and that after a vertebral fracture they usually keep impact to the level of brisk walking. It also found that exercise may help pain, mobility and quality of life after a vertebral fracture, ideally with specialist advice (Brooke-Wavell et al., 2022). For someone who sits all day, that makes a review with a physiotherapist worth considering; how much physiotherapy costs explains the NHS and private routes.
When to see a doctor
See a GP if back pain isn’t getting better after a few weeks, if your spine becomes curved or your posture hunched, or if you think you may be at risk of osteoporosis. Ask for an urgent GP appointment or contact NHS 111 if you’ve recently had a fall or injury and the pain isn’t easing. Call 999 or go to A&E for severe pain after a fall or injury (NHS). Back pain with numbness or weakness in both legs, loss of feeling around the genitals or anus, or changes in bladder or bowel control also needs 999 or A&E (NHS). These are among the red flags that call for urgent care.
Questions people ask
What does a vertebral compression fracture feel like?
It can cause sudden back pain and muscle spasms, but it doesn't always hurt the way a broken bone is expected to, and the pain can be mistaken for arthritis. Height loss and a more curved upper back are other signs, especially after several fractures.
How long does a spinal compression fracture take to heal?
The Royal Osteoporosis Society says a spinal fracture takes 6 to 12 weeks to heal. The bone heals in its new, compressed shape, and some people have ongoing pain after it has healed.
Can an osteoporotic spinal fracture cause paralysis?
The Royal Osteoporosis Society says not. Fractures caused by osteoporosis are stable, meaning they are not going to move and damage the spinal cord.
Should I keep moving with a vertebral fracture?
Generally yes. Staying as active as possible is recommended, and movement does not affect healing. A UK consensus advises avoiding deep forward bending and, after a vertebral fracture, usually keeping impact to the level of brisk walking, ideally with specialist advice.
Terms on this page
- OsteoporosisA long-term condition that makes bones weak and easier to break, often without symptoms.
- VertebraOne of the 33 bones stacked to form the spine, from the neck down to the tailbone.
- Thoracic kyphosisThe natural outward curve of the upper back, and when it becomes hyperkyphosis.
- X-rayAn imaging test that shows bones well, and when it is, and isn't, useful for back and neck pain.
- Bone densityHow dense, and so how strong, your bones are, usually measured with a DEXA scan.
- Red flagsWarning signs that back or neck pain could have a serious cause and needs a doctor promptly.
Sources
- Royal Osteoporosis Society. Osteoporosis symptoms. Last reviewed 17 September 2026.
- Royal Osteoporosis Society. Spinal fractures (vertebral fractures).
- NHS. Osteoporosis.
- Fink HA et al. What proportion of incident radiographic vertebral deformities is clinically diagnosed and vice versa? Journal of Bone and Mineral Research, 2005.
- Delmas PD et al. Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT study. Journal of Bone and Mineral Research, 2005.
- Klotzbuecher CM et al. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. Journal of Bone and Mineral Research, 2000.
- Lindsay R et al. Risk of new vertebral fracture in the year following a fracture. JAMA, 2001.
- Brooke-Wavell K et al. Strong, steady and straight: UK consensus statement on physical activity and exercise for osteoporosis. British Journal of Sports Medicine, 2022.
- NHS. Back pain.
This page explains a topic in general terms. It is not a diagnosis and does not replace a doctor or physiotherapist. If something hurts badly, keeps getting worse or comes with numbness, weakness or fever, see a doctor.
