A work-related spinal compression fracture may cause little or no pain at first. Sometimes pain is centered over the area where the fracture has occurred. The collapsed vertebra gives the spine a hunched appearance, and the loss of vertebral height shortens the muscles on each side of the spine. This forces the back muscles to work harder, causing muscle fatigue and pain. When pain does occur, it usually goes away after a few weeks. However, back pain sometimes escalates to the point that patients seek medical help.
Traumatic compression fractures can produce intense pain in the back that spreads into the legs. If the fracture severely damages the vertebral body, bone fragments may lodge in the spinal canal, pressing on the spinal cord. Such a fracture may also cause the spine to become unstable. When this happens, the spine eventually tilts forward into increased kyphosis, and the potential grows for future complications with the spinal cord.
Diagnosis begins with a complete history and physical examination. This is where a complete description of the work accident is important. The doctor asks questions about symptoms and how the problem is affecting daily activities. These include questions about where one feels pain and if there is numbness or weakness in the limbs. The doctor will also want to know what positions or work activities make your symptoms worse or better.
Then the doctor examines to see which back movements cause pain or other symptoms. Skin sensation, muscle strength, and reflexes are also tested. The doctor uses gentle pressure to feel the tissues over the sore area, since compression fractures often cause soreness and tenderness in the muscles over fractured vertebra.
If the doctor believes there is a compression fracture, X-rays are ordered. When an X-ray confirms a compression fracture, computed tomography (a CT scan) may be ordered. This is a detailed X-ray that lets the doctor see slices of the body’s tissue. The image can show whether the compression fracture has caused the area to become unstable from the injury.
The doctor may combine the CT scan with myelography, a special dye injected into the space around the spinal canal (the subarachnoid space).
Magnetic resonance imaging (MRI) can show the doctor problems affecting the nerves or causing pain. The MRI shows problems in other soft tissues such as the discs and spinal cord.
The doctor may order a bone scan to get additional information. This test can show if there are any old compression fractures, which would alert the doctor to problems with osteoporosis.
McCormick Law Office in Milwaukee, Wisconsin represents injured workers with compression fractures, often in the thoracic vertebrae. We obtain disability benefits and medical bill payments.