What causes vertebral compression fracture?

Osteoporosis is a very common cause: reduced bone strength can allow a vertebra to compress during an ordinary movement, a cough, or a minor fall. A stronger force, such as a road collision or a fall from height, can fracture a healthy vertebra as well. Less commonly, another condition affecting bone may weaken the spine. Pain is often sudden and focused in the back, and standing, walking, coughing, or bending may make it worse. Some fractures cause height loss or a more rounded posture, while others have few early symptoms.

The cause cannot be confirmed from pain alone. A clinician may consider the injury, bone-health risks, examination findings, and imaging.

Contact a clinician promptly for new severe back pain after a fall or forceful event, or for sudden pain without a clear injury. Until assessed, avoid heavy lifting, forceful bending, and twisting. Keep moving carefully if able, but do not push through sharp pain. Medical care may include imaging, pain management, activity guidance, and evaluation for osteoporosis or another underlying cause. Follow-up can also address safe strengthening and fall prevention.

Seek emergency help for new leg weakness, numbness around the groin, loss of bladder or bowel control, or inability to stand safely. Get urgent assessment for fever with back pain, a history of cancer, unexplained weight loss, or pain that is rapidly worsening. These features can signal a problem needing treatment beyond a simple strain.

Could this be a compression fracture, and what imaging is needed? Should my bone strength be checked? Which activities are safe while the spine heals? What steps can reduce future falls or fractures?