Spinal Fractures and Osteoporosis: Treatment, Recovery and Living Well

Most spinal fractures caused by osteoporosis heal on their own within about 6 to 12 weeks, with pain relief, gentle activity and time. The Royal Osteoporosis Society says "a spinal fracture takes between 6 and 12 weeks to heal" Royal Osteoporosis Society. Surgery is rarely needed. The bigger long-term priorities are managing pain, staying active and treating the osteoporosis so another bone does not break.

What is a spinal fracture caused by osteoporosis?

A spinal fracture is when one of the bones of the spine (a vertebra) becomes compressed or squashed because it has lost strength. The Royal Osteoporosis Society (ROS) explains that it is also called a vertebral fracture or a compression fracture Royal Osteoporosis Society.

An NHS patient leaflet explains that in a healthy person the front part of each vertebra (the vertebral body) is dense and strong, but it can be weakened by disease. These low-energy fractures most commonly happen because of osteoporosis, and often in the mid and lower back EPUT NHS leaflet, 2025. You may not be able to point to a specific fall or injury.

If you are not sure whether you have had one, our guide to losing height and osteoporosis covers the warning signs. This guide is about what happens next.

What is a wedge fracture?

A wedge fracture is the most typical shape of osteoporotic spinal fracture: the front of the vertebral body collapses, so the bone becomes wedge-shaped. Compression fractures "usually occur when the front of the vertebral body collapses" Primary Care Notebook. The ROS explains that spinal bones do not go back to their previous shape, which can cause height loss, a change in body shape and an outward curve at the top of the spine Royal Osteoporosis Society.

How long does a fractured vertebra take to heal?

A vertebral compression fracture generally takes 6 to 12 weeks to heal, and most people can expect the bone to have healed within about three months. The ROS gives both of these timeframes Royal Osteoporosis Society, and NHS leaflets also give 6 to 12 weeks Leeds Community Healthcare NHS.

The bone healing and the pain do not always follow the same timeline. One NHS leaflet notes that you can expect to recover well, but occasionally the pain does not go away completely EPUT NHS leaflet, 2025. The ROS says pain still present after three months is described as chronic pain Royal Osteoporosis Society. For more on timelines for other bones, see how long a fracture takes to heal.

How is a fractured vertebra treated?

Most osteoporotic spinal fractures are treated without surgery, using pain relief, activity and physiotherapy. The EPUT leaflet says "in most cases vertebral compression fractures heal on their own with conservative treatment" EPUT NHS leaflet, 2025, and Leeds Community Healthcare says "you would not usually need an operation and it is recommended you remain active" Leeds Community Healthcare NHS.

Pain relief

Because a spine cannot be put in a cast or offloaded like a broken wrist, sitting and standing can be very uncomfortable. That is why NHS leaflets stress taking enough pain relief to keep moving EPUT NHS leaflet, 2025. Some people manage with paracetamol or ibuprofen. Others need stronger, prescription-only medicines at first, which can be reduced as pain improves. Discuss the benefits and risks with your GP, and only take prescription medicines prescribed for you. Our guide to whether osteoporosis causes pain covers the options, from paracetamol to TENS and pain clinics.

Staying active

The ROS advises resting for a while if pain is severe in the early stages, then using pain relief to help you stay active Royal Osteoporosis Society. Staying as active as possible lowers the risk of chest infections, constipation and blood clots.

The EPUT leaflet adds that avoiding activity completely can weaken your bones further and cause muscle weakness and stiffness. It advises avoiding heavy lifting (anything heavier than a kettle) and repeated bending in the first few weeks, because these strain the healing bone EPUT NHS leaflet, 2025.

Exercise and physiotherapy

You do not need to wait for the fracture to heal before starting gentle exercise. The EPUT leaflet says you do not need to wait 6 to 12 weeks, and that starting gentle exercises as soon as you feel able helps improve muscle tone, ease tension and reduce muscle spasm EPUT NHS leaflet, 2025. Leeds Community Healthcare advises starting gently and building up "as you increase in confidence" Leeds Community Healthcare NHS.

A physiotherapist can give you a structured programme and a walking aid if needed. Once you are ready, see our guides to osteoporosis spine exercises and posture exercises for osteoporosis.

How should you sit and sleep with a fractured vertebra?

There is no single correct position. The aim is to stay supported, change position often and keep pain under control so you can keep moving. NHS leaflets acknowledge that sitting and standing may be very uncomfortable after a spinal fracture EPUT NHS leaflet, 2025. Some general comfort tips (ask your physiotherapist what suits you):

• Use a firm, supportive chair rather than a low, soft sofa that is hard to get out of.
• Change position often and get up and move around regularly, rather than sitting for long periods.

For sleeping, the EPUT leaflet suggests extra pillows to support your knees and spine: a pillow under your knees if you sleep on your back, or between your knees if you sleep on your side EPUT NHS leaflet, 2025.

A physiotherapist or occupational therapist can assess your home and give advice tailored to you, including equipment such as raised chairs or toilet seats.

When is surgery used for a spinal fracture?

Surgery is only considered for a small number of people with severe, ongoing pain from a recent fracture that has not healed, despite the best possible pain relief. The EPUT NHS leaflet says surgery may be considered when the pain has been confirmed to come from the level of the fracture by examination and imaging EPUT NHS leaflet, 2025. NICE supports vertebroplasty and balloon kyphoplasty as options in these selected patients Primary Care Notebook.

The two procedures are:

• Vertebroplasty: bone cement is injected into the broken vertebra to help stabilise it.
• Kyphoplasty: a balloon is inserted into the broken vertebra and inflated to create space, which is then filled with cement.

The ROS notes that these procedures "don't improve bone strength, or reduce your risk of breaking another bone", are done in only a few UK specialist centres, and carry risks including cement leaks, infection and nerve injury Royal Osteoporosis Society.

What is the life expectancy after a compression fracture?

Many people live for many years after a spinal fracture, and a single fracture does not set a life expectancy. But studies do show that clinical spinal fractures are linked to a higher risk of death, especially in the first year. This is a hard question, so here is what the evidence actually says.

A review in Clinical and Experimental Rheumatology found that many studies show a rise in mortality after a clinical vertebral fracture, with the extra risk greatest in the first year Teng et al., 2008. The same review is careful about what this means:

• Frailty, other illnesses and lifestyle factors explain a significant part of the extra risk. Most studies found higher death rates after a vertebral fracture in men than in women.
• Fractures found only on an X-ray, without symptoms, have shown weaker links. In one study, a single radiographic fracture was not linked to higher mortality, while having two or more was.
• How much of the link is directly caused by the fracture is still uncertain.

The honest takeaway is that a spinal fracture is a warning sign about your overall health and your bones. It is a reason to act, not a countdown. The most useful things you can do are keep active, prevent falls, and get your osteoporosis treated so another fracture is less likely.

How do you prevent another spinal fracture?

Treating the underlying osteoporosis is the most important step after a spinal fracture. If you have had a low-energy fracture, you may be offered a bone health review and a DXA scan, and if your risk of further fracture is high you are likely to be offered bone-strengthening medicine EPUT NHS leaflet, 2025. UK guidance (NOGG) recommends first-line treatment with an oral bisphosphonate (alendronate or risedronate) or intravenous zoledronate, and referral to a specialist for people at very high risk, some of whom may need an anabolic medicine first NOGG, 2024. See our guides to osteoporosis treatment, zoledronic acid and teriparatide.

NOGG also recommends assessing falls risk in people with fragility fractures, and offering an exercise programme to improve balance and muscle strength NOGG, 2024. Stopping smoking and cutting down on alcohol also help protect bone.

Once you are on treatment, some people want a way to keep an eye on their bone health between NHS scans. Screen My Bones offers radiation-free REMS (Radiofrequency Echographic Multi Spectrometry) screening at partner venues, an ultrasound-based scan that does not use ionising radiation. It is a screening and monitoring option, not a diagnostic test, and UK guidance does not recommend REMS for diagnosing osteoporosis. Please discuss any result with your GP. You can read about REMS technology.

Where can you get support?

The NHS notes that a broken bone in the spine can cause a hunched posture and pain that may become long-term, and that your GP or nurse can help NHS. The Royal Osteoporosis Society runs a helpline staffed by specialist nurses, as well as local support groups. If you are new to the condition, start with our guide to what osteoporosis is.

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This article is part of our bone health series. It is general information, not medical advice. Speak to your GP or physiotherapist about your own recovery.