Pain guide · Back pain

Spinal compression fracture: recovering, exercising and living with an osteoporotic spinal fracture

A spinal compression fracture is when a bone in the spine, weakened by osteoporosis, squashes down, often after a minor fall, a lift or even a cough. It can be very painful at first, or hardly noticed. The bone usually heals in about 6 to 12 weeks, but keeps its new shape, which can mean height loss and a more curved upper back.

Your team's plan comes first. This guide sets out the usual stages: keep moving and start gentle back exercises straight away, then build strength and balance once the bone has healed. It covers pain relief, braces and cement procedures, what to modify, and why a bone health check matters. The osteoporosis exercise guide covers bone-building exercise for everyone.

3-stage exercise plan When to get help 37 sourcesUpdated 21 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Call 999: after a fall, you may have hurt your head, neck, back or hip, or you cannot get up.
Call 999 or go to A&E: loss of feeling or numbness around the genitals or bottom, new trouble peeing or controlling your bladder or bowels, changes in genital sensation during sex or problems with erections or orgasm, or pain, tingling, weakness or numbness in both legs. These are signs of cauda equina syndrome, which needs treating in hospital urgently. Don't drive yourself.
Same day: new numbness, pain or weakness in your legs after a spinal fracture. Very occasionally a piece of broken bone presses on the nerves, and an NHS trust says it needs to see you urgently if this happens. Contact your fracture team or GP, or call NHS 111.
Call 999 or go to A&E: back pain with chest pain, or back pain that started after a serious accident, such as a car crash.
Call 999: sudden, severe pain in the tummy or back, which can come with breathlessness, pale or grey skin, or collapse. It can be a burst abdominal aortic aneurysm, most common in men aged 65 or over and in people who smoke or used to smoke.
Same day: you have or have had cancer, and new back pain that is severe and doesn't let up, is getting steadily worse, is worse at night and disturbs your sleep, is worse when you cough, sneeze or strain, or comes with tenderness over the spine. Contact your cancer team or GP urgently. With cancer, new weakness, difficulty walking, numbness or bladder or bowel problems are an emergency.
Same day (GP or NHS 111): back pain and you feel hot, cold, shivery or generally unwell, or severe pain that starts suddenly or is getting worse quickly.
Call 999: calf or leg pain or swelling with breathlessness or chest pain. It could be a clot that has reached the lungs. Do not drive yourself to A&E.
Same day (GP or NHS 111): throbbing pain and swelling in one leg, usually the calf or thigh, with red, blue or darker skin or swollen veins. It could be a blood clot (deep vein thrombosis, DVT), which is more likely while you're moving about much less than usual or after a hospital stay.
After vertebroplasty or kyphoplasty: redness, warmth, swelling or fluid where the needle went in, or a fever, needs a same-day call to the team that did it or NHS 111.

See a doctor or physiotherapist if

Sudden new back pain after a minor fall, lift, cough or sneeze, from 50 or past the menopause, or if you take long-term steroid tablets; or height loss, a curved spine or a change in posture: see a GP. It can be a spinal fracture.
You're 50 or over, or past the menopause, and have broken a bone: ask your GP about a fracture risk assessment. The National Institute for Health and Care Excellence (NICE) offers a bone density scan after a spinal fragility fracture.
Severe pain that isn't easing despite pain relief, or pain that is still significant after about 3 months: ask your GP about your options.
Breathlessness, or a squashed and bloated stomach, as your back becomes more curved: see a GP.
You've had a fall, or you're worried about your balance or getting about: see a GP.

Understand it

What it isStrong evidence

In a spinal compression fracture, a bone in the spine (a vertebra) "becomes compressed or squashed after losing strength", as the Royal Osteoporosis Society puts it. Usually the front of the bone collapses, making a wedge. You may hear it called a vertebral fracture.

With osteoporosis it takes little force: a fall, reaching, twisting, a cough or a sneeze, or nothing you can pinpoint. These fractures are most common around the waistline, where the mid back meets the lower back, but can happen above or below it. Less often, a vertebra collapses because of cancer or another tumour in the bone, which is why a history of cancer matters.

Sources 1, 2, 3, 4, 5

Common, and often missedStrong evidence

Spinal fractures are the most common fracture caused by osteoporosis, but many cause no symptoms, so many are never diagnosed. The UK's National Osteoporosis Guideline Group (NOGG) says most spinal fractures don't come to medical attention. One in two women and one in five men over 50 will break a bone, mainly because of poor bone health.

Sources 6, 7, 4

How it's recognised

Sudden back pain, often worse when you move or change position, eased by lying down and made worse by coughing or sneezing. Or a gradual change: height loss, a curved spine or change in posture, unexplained back pain and muscle spasms. Some fractures don't cause the pain you'd expect, and the pain can be mistaken for arthritis.

NOGG asks GPs to think of a spinal fracture in women past the menopause and men aged 50 or over with sudden back pain, especially in the mid back, and risk factors, and to consider spine imaging with height loss of 4 cm or more, a curved upper back, or long-term steroid tablets. NICE suggests considering a spine check at the same visit as a bone density scan for women from 60 and men from 70. An X-ray confirms a fracture, and an MRI (magnetic resonance imaging) scan can show whether it is new.

Sources 2, 8, 7, 6

How it heals, and how long the pain lastsEmerging evidence

A spinal fracture takes about 6 to 12 weeks to heal, and "you can usually expect your broken bone to heal within about three months". It heals in its new, squashed shape. The pain usually gets better as it heals, and most people feel better within 3 months without surgery.

Some people have pain for longer. In the comparison group of one vertebroplasty trial, people treated without the procedure, 40% still had significant pain at a year, and nothing predicted who would. People in trials may differ from typical patients, so this may not apply to you. Pain that lasts after healing comes from the change of shape: irritated nerves, muscle spasm, and strain on joints and ligaments. Posture and back exercises may help with some of these symptoms, but they can't reverse a change of shape caused by fractures.

Sources 1, 9, 2, 10, 11

Paralysis is not expected

The Royal Osteoporosis Society says osteoporotic spinal fractures are "stable" and "do not cause paralysis". An NHS trust adds that, very occasionally, a fragment presses on the nerves, causing leg numbness, pain or weakness, and very rarely cauda equina syndrome. NOGG asks for urgent referral to a spinal surgeon if a fracture comes with nerve problems.

Sources 8, 4, 7

The next fractureStrong evidence

Among 381 women with a new spinal fracture in the placebo groups of 4 trials, 19.2% had another within a year: about 1 in 5. Osteoporosis medicines cut new spinal fractures by 40% to 70%, and exercise adds to medicine rather than replacing it. NICE offers a bone density scan after a spinal fragility fracture and suggests considering bone medicine.

Sources 12, 13, 14, 15, 6

What helps, and how strong the evidence is

Keep moving from the startStrong evidence

The Royal Osteoporosis Society advises staying as active as possible: movement doesn't affect healing, and staying active lowers the risk of chest infections, constipation and blood clots. If pain is severe at first, rest for a while, then use pain relief to keep moving. An NHS trust adds that avoiding activity completely can weaken bones and muscles further, and advises against heavy lifting (more than a kettle) and repeated bending for the first few weeks.

Gentle back exercises can start straight away: "You do not need to wait 6-12 weeks for your fracture to heal before you start exercising", says the trust, and the Royal Osteoporosis Society says its back exercises can start "as soon as you feel ready". NOGG suggests starting back-muscle exercise lying down if you're in pain, and the UK consensus recommends prompt advice on moving and lifting and a referral to a physiotherapist. This is consistent expert advice rather than something trials have tested.

Sources 1, 9, 4, 7, 15

Strength and balance, once the bone has healedEmerging evidence

The Royal Osteoporosis Society says to wait until the bone has healed before building up strength exercise: "The healing process can take up to three months." NOGG strongly recommends exercise after a spinal fracture that includes progressive strength work, including the back muscles. The international Too Fit To Fracture recommendations advise strength training at least twice a week (8 to 12 repetitions, 2 sets, starting lighter at high fracture risk) and balance training of 15 to 20 minutes a day, rather than aerobic exercise alone, with a physiotherapist's advice.

The UK consensus, Strong, Steady and Straight, recommends back-muscle exercise, strength and balance training, and impact no higher than brisk walking (about 20 minutes a day) "because of theoretical (unproved) risks". A UK trial's programme aimed for about an hour of exercise on 3 to 5 days a week, such as a 30-minute walk plus 30 minutes of stretches, balance and strength.

Sources 16, 7, 13, 15, 17

How well exercise works: modest gains, uncertain effectsMixed evidence

A Cochrane review of 9 trials (749 people) found exercise probably makes the Timed Up and Go test (standing up, walking 3 metres and sitting back down) about 1 second faster, which the authors didn't think clinically important. Effects on new fractures, falls, pain and quality of life were uncertain, and there were 4 exercise-related harms, including a broken rib.

In a UK trial of 615 people (average age 72), seven physiotherapy sessions of exercise improved balance, mobility and walking at 4 months compared with a single session of advice, but at a year neither exercise nor hands-on therapy beat the single session. Many people found it hard to keep exercising. An American bone research task force concluded that exercise may improve mobility and reduce pain and fear of falling, but doesn't reduce falls or fractures. The UK consensus calls its own advice for people with fractures consensus-based.

Sources 18, 19, 20, 14, 15

Pain relief: enough to keep you movingEmerging evidence

An NHS trust says to take enough pain relief to keep moving. NOGG advises the weakest medicine that works for the shortest time, avoiding anti-inflammatory painkillers such as ibuprofen in older people or protecting the stomach if they're used, and laxatives whenever opioids are used. It says calcitonin, given in hospital in the first days, can ease acute pain for a few weeks, but it isn't for long-term use.

A 2024 review of 20 trials found calcitonin and anti-inflammatory painkillers eased short-term pain on activity compared with placebo, and that evidence on other painkillers and braces is limited. The NHS also lists heat and cold treatments and relaxation. Ask your GP or pharmacist what suits you.

Sources 4, 7, 21, 3

Braces: for comfort, if offeredMixed evidence

NOGG says there is no evidence that braces improve healing and that routine bracing can't be recommended. In 284 women aged 65 to 85 with a fresh fracture, 12 weeks in a rigid brace did no better than a soft brace for further collapse, quality of life or pain at 48 weeks.

Pooling 3 trials (447 people), a rigid brace eased pain compared with no brace at 3 to 6 months but not at 48 weeks, and changed nothing else: not the curve, painkiller use, function or quality of life. A review of 16 studies found no convincing evidence that a rigid brace beats a soft one or none. One trial of a posture brace worn for 6 months reported stronger back muscles, a smaller curve and less pain. If your team offers a brace for comfort in the first weeks, a soft one did as well as a rigid one in a large trial.

Sources 7, 22, 23, 24, 25

Vertebroplasty: no better than a sham procedureStrong evidence

Vertebroplasty injects bone cement into the broken bone. A Cochrane review found high- to moderate-quality evidence from 5 sham-controlled trials (541 people) that it gives no clinically important benefit: pain was 0.7 points out of 10 better at a month, below the 1.5 points that matter. Serious harms reported across trials include infection, pressure on the spinal cord and breathing failure. One sham-controlled trial in fractures under 6 weeks old with severe pain found more people under 4 out of 10 at 14 days (44% against 21%).

NICE recommends vertebroplasty or balloon kyphoplasty only for severe, ongoing pain after a recent, unhealed fracture despite the best pain relief, with the pain confirmed at that level by examination and a scan. NOGG says the evidence doesn't support routine use, and the Royal Osteoporosis Society says the procedures don't improve bone strength or reduce the risk of another fracture, and aren't suitable for most people.

Sources 26, 27, 5, 7, 1

Kyphoplasty: an open trial, and doubtsMixed evidence

Balloon kyphoplasty uses a balloon to make space in the bone before the cement goes in. In a trial of 300 people where everyone knew their treatment, quality of life improved more at 1 month than with non-surgical care. An American bone research task force found too little evidence that kyphoplasty beats non-surgical care, and concluded that routine cement procedures aren't supported.

Sources 28, 14

How much pain is OK while you exercise?

While it heals, move as far as pain allowsEmerging evidence

While the bone heals: move slowly into each position, as far as your pain allows. If pain is very severe at first, alternate short spells of gentle movement with rest. Exercise won't damage the healing bone: the Royal Osteoporosis Society says many people fear it will, "but this isn't the case". An NHS trust says be as active as pain will allow, and movement doesn't affect healing.

Once you're building strength: it's normal to feel stiff or sore for a few days after new exercises. Stop if you feel any pain during exercise, or if you feel sick, dizzy, very short of breath, clammy or tight in the chest, and put a weight down if you feel strain in your back, then go lighter or change your technique (Royal Osteoporosis Society).

Our suggestion: sharp pain, pain that spreads round the ribs, or back pain that is worse the next day means do less next time. Numbness, weakness, or bladder or bowel changes are not a pain-rule question: see the warning signs.

Sources 9, 4, 1, 16

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

From the start: keep moving and ease the pain (while the bone heals, about 6 to 12 weeks)

As your team allows, from the first days. Stay as active as pain allows. Do the back exercises at least once a day, moving only as far as pain allows, and alternate gentle movement with rest at first if the pain is severe. For the first few weeks avoid heavy lifting (more than a kettle) and repeated bending. In bed, try a pillow under your knees on your back, or between them on your side. Timings and doses are built from the Royal Osteoporosis Society's fact sheets and consensus and from Too Fit To Fracture (our summary); where no source gives a number, they are editorial.

Treadmill walking demonstrated on the 3D figure

3D demoTreadmill walkingBeginner · Cardio machine

Short walks several times a day, building towards 20 min a day, no faster than brisk · Walking outdoors counts, and 10-minute bouts are fine

Harder: Treadmill jogging

Seated upper-back lift (sit tall, shoulders back) demonstrated on the 3D figure

3D demoSeated upper-back lift (sit tall, shoulders back)Beginner · A bench or box

Hold 3 to 5 s, up to 10 times, at least once a day · The Royal Osteoporosis Society's shoulder squeeze. Stop if pain spreads round the ribs

Easier: Elbows back · Harder: Prone Y-T-W raises

3D demoCat-cowBeginner · No equipment

Hold each end 3 to 5 s, up to 10 times, once a day · The Royal Osteoporosis Society's cat, as far as pain allows

Harder: Half lord of the fishes (Ardha Matsyendrasana)

Glute bridge demonstrated on the 3D figure

3D demoGlute bridgeBeginner · No equipment

Hold 3 to 5 s, up to 10 times, once a day · The Royal Osteoporosis Society's bridge, only as high as is comfortable

Easier: Pelvic tilt into bridge · Harder: Glute kickback (quadruped hip extension)

3D demoChin tuckBeginner · No equipment

Hold 2 s, as many times as is comfortable, on 2 or 3 days a week · From the Royal Osteoporosis Society's posture fact sheet

Easier: Lying chin tuck · Harder: Isometric neck holds (four-way)

Lateral breathing (Pilates breathing) demonstrated on the 3D figure

3D demoLateral breathing (Pilates breathing)Beginner · No equipment

5 to 8 slow breaths · The UK consensus recommends breathing exercises for symptoms that a very curved upper back can make worse

Harder: Roll-up (Pilates)

Move on when: As your team allows: usually once the fracture has had time to heal (often 6 to 12 weeks, and up to 3 months), the pain is easing and walking is easier.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Once the bone has healed: strength and balance (from about 6 to 12 weeks)

As your team allows, with a physiotherapist's advice before you build up strength work after a painful spinal fracture. Strength on 2 or 3 days a week with a rest day between, 8 to 12 repetitions, building to 3 sets; balance on most days. Keep the stage 1 back exercises and walking going, and keep impact to brisk walking. The first four moves follow the Royal Osteoporosis Society's level 1 exercises, which it says suit people returning to exercise after a broken bone. Timings and doses are built from the Royal Osteoporosis Society's consensus and Too Fit To Fracture (our summary); the hold times are editorial.

Sit to stand from a chair demonstrated on the 3D figure

3D demoSit to stand from a chairBeginner · A bench or box

8 to 12, building to 3 sets

Harder: Bodyweight squat

Wall push-up demonstrated on the 3D figure

3D demoWall push-upBeginner · A wall

8 to 12, building to 3 sets

Harder: Push-up

3D demoBand rowBeginner · A band + An anchor point

8 to 12, building to 3 sets

Harder: Supported single-arm dumbbell row

Knee side plank demonstrated on the 3D figure

3D demoKnee side plankBeginner · No equipment

2 or 3 holds of 10 to 20 s each side, once or twice a week

Harder: Side plank

Low cobra (Bhujangasana) demonstrated on the 3D figure

3D demoLow cobra (Bhujangasana)Beginner · No equipment

3 to 5 lifts, each held 3 to 5 s, on most days, building towards 10 · Back-muscle strength. If lying face down is uncomfortable, use the seated upper-back lift

Harder: Cobra pose (Bhujangasana)

Tandem stance and heel-to-toe walk demonstrated on the 3D figure

3D demoTandem stance and heel-to-toe walkBeginner · A wall

Holds of about 10 s by a worktop, then the walk; balance work building to 15 to 20 min a day in short bouts

Easier: Semi-tandem stance · Harder: Single-leg stand

Move on when: These feel steady for a few weeks, and the pain is no worse the next day.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Stronger for the long term (from about 3 months)

As your team allows, with a physiotherapist's or qualified instructor's advice. The strength moves follow the Royal Osteoporosis Society's level 2 exercises, using body weight, bands and light weights; keep a push from stage 2 in each session, and learn heavier lifts only with a qualified instructor. Everyday strength counts too, such as carrying shopping and gardening. Timings and doses are built from the Royal Osteoporosis Society's consensus and Too Fit To Fracture (our summary); the balance hold is editorial.

Dumbbell goblet squat demonstrated on the 3D figure

3D demoDumbbell goblet squatIntermediate · A dumbbell

8 to 12, building to 3 sets

Easier: Bodyweight squat · Harder: Back squat with bands

3D demoStep-upBeginner · A step

8 to 12 each leg, building to 3 sets · A low step and a rail to hold at first

Easier: Low step-up · Harder: Dumbbell step-up

Supported single-arm dumbbell row demonstrated on the 3D figure

3D demoSupported single-arm dumbbell rowIntermediate · A dumbbell + A bench or box

8 to 12 each side, building to 3 sets

Easier: Incline ring row · Harder: Bent-over barbell row

Hip-hinge practice demonstrated on the 3D figure

3D demoHip-hinge practiceBeginner · No equipment

8 to 12 · Then a light Romanian deadlift, once a physiotherapist or instructor has checked your technique

Harder: Dumbbell Romanian deadlift

Locust pose (Salabhasana) demonstrated on the 3D figure

3D demoLocust pose (Salabhasana)Beginner · No equipment

3 to 5 lifts, each held 3 to 5 s, at least twice a week, building towards 10 · Lower the chest if your back pinches

Harder: One-legged bow (half locust)

Single-leg stand demonstrated on the 3D figure

3D demoSingle-leg standBeginner · A wall

Build from 10 s with support to 30 s without, each leg, on most days

Easier: Tandem stance and heel-to-toe walk · Harder: Single Leg Reach Matrix

Move on when: Keep going: 2 or 3 strength days and balance on most days. The osteoporosis exercise guide's plans are the long-term home; keep impact to brisk walking unless your physiotherapist advises more.

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

Typical timings, which your team may change

Built from the Royal Osteoporosis Society's consensus and Too Fit To Fracture (our summary), with an NHS trust's leaflet. Your own team's timings come first.

Gentle back exercises: from the first days, at least once a day, held 3 to 5 s, up to 10 times.
Heavy lifting (more than a kettle) and repeated bending: avoided for the first few weeks.
Healing: usually 6 to 12 weeks, and up to 3 months.
Building up strength work: once the bone has healed, ideally with a physiotherapist's advice.
Strength: 2 or 3 days a week, 8 to 12 repetitions, building to 3 sets.
Posture exercises: 2 or 3 days a week, with a rest day between.
Balance: 15 to 20 minutes a day in short bouts, building up.
Walking: about 20 minutes a day (150 minutes a week), no more impact than brisk walking.

Sources 9, 4, 16, 29, 11, 15, 13

Bending is not banned

The Royal Osteoporosis Society says "moving around and bending forward is generally safe and won't cause a spinal fracture". What the UK consensus asks you to modify is sustained, repeated or end-of-range rounding, and rounding the back with a load. Bend from the hips with a long back when you lift. The consensus asks for advice on "how to" rather than "don't do".

Sources 30, 31, 15

Everyday life

Ask for help with heavy jobs at first, use a trolley rather than carrying a basket, and lift light things close to your body. Too Fit To Fracture advises putting weights down by bending your knees rather than dropping them, turning over slowly (for example from your back onto your front), and avoiding exercise machines you have to bend or twist to use or adjust.

Sources 4, 32, 13

Bone health and falls

Ask your GP about a bone health check: NICE offers a bone density scan after a spinal fragility fracture and suggests considering bone medicine, and NOGG recommends starting treatment promptly, with follow-up through a fracture liaison service where there is one. If you've fallen or feel unsteady, see a GP about your balance too.

Sources 6, 7, 33

Positions to swap, and why

Habit or position	Why it matters	Instead
Staying in bed until it heals	Movement doesn't affect healing, staying active lowers the risk of chest infections, constipation and clots, and avoiding activity can weaken bones and muscles.	Short walks several times a day, as pain allows.Try: Treadmill walking
Heavy lifting and repeated bending in the first weeks	An NHS trust advises lifting nothing heavier than a kettle and avoiding repeated bending early on.	Ask for help, use a trolley, and later lift light things close to you with a hip hinge.Try: Hip-hinge practice
Sit-ups, crunches, toe touches and Pilates roll-downs	The UK consensus asks you to modify sustained, repeated or end-of-range rounding of the spine, and the crunch and roll-down pages say the same.	The dead bug and the knee side plank instead.Try: Dead bug
The Jefferson curl, or lifting with a rounded back	The consensus advises against curving the back with a load, and the Jefferson curl's page says to avoid it after a spinal fracture.	Hinge from the hips with a long back.Try: Hip-hinge practice
Russian twists with a weight	They load the spine while it is rounded and twisted, and the move's page says to leave it out after a spinal fracture.	The Pallof press, once your team is happy for you to build strength.Try: Half-kneeling Pallof press
Jumping and high-impact exercise	After a spinal fracture, the UK consensus keeps impact to about brisk walking, as a precaution against unproved risks.	Brisk walking. Ask a physiotherapist before anything harder.Try: Treadmill walking
Foam roller extensions over the spine	The roller's own page says to clear it first if you have osteoporosis.	The seated upper-back lift, or the low cobra once your team allows.Try: Seated upper-back lift (sit tall, shoulders back)
Dropping weights, or turning over quickly from your back onto your front	Too Fit To Fracture reports fractures happening this way in people with spinal fractures.	Slow, controlled movements, and put weights down by bending your knees.
Exercise machines you have to bend or twist to use or adjust	Too Fit To Fracture advises avoiding them unless you can use and adjust them with good form.	Bands and free weights you can hold at chest height.Try: Band row
Wearing a rigid brace for months	Routine bracing isn't recommended, and a soft brace did as well as a rigid one in a large trial.	Follow your team's advice, and build strength and posture with exercise.Try: Seated upper-back lift (sit tall, shoulders back)

Routines to follow

Kyphosis exercises for seniors: a spine-strengthening routine

A 30-minute routine for a rounded upper back in later life, built from the SHEAF trial: floor back-strengthening, posture practice and gentle mobility.

30 minBeginner13 movesA bench or box, A wall

Chair exercises for seniors: a seated workout

A 20-minute seated workout for older adults who cannot stand for long: marching, leg and arm strength, posture, and sit-to-stands that lead back to standing.

20 minBeginner11 movesA bench or box, Something with weight

Strength and balance exercises for seniors

A 40-minute strength and balance session for over-65s, built from the Otago home programme and NHS exercises, using a chair, a counter and a step.

40 minBeginner18 movesA bench or box, Something with weight

Balance exercises routine

Balance practice in 10 minutes: tandem stance, single-leg stands, marches, heel walks, tree pose and floor transfers.

10 minBeginner7 movesA wall, A bench or box

Strength and balance workout

Strength and balance in one session: squats, Romanian deadlifts, push-ups, rows, step-ups, back extensions, carries and single-leg balance.

45 minBeginner14 movesA wall, A dumbbell

More moves for this area

Questions people ask

How long does a compression fracture take to heal?

The bone usually heals in 6 to 12 weeks, in its new compressed shape. Pain usually eases as it heals, but some people have pain for longer: in the comparison group of one vertebroplasty trial, 40% still had significant pain at a year. People in trials may differ from typical patients, so ask your team what to expect.

Can I exercise with a compression fracture?

Yes, gently, from the start: the Royal Osteoporosis Society and an NHS trust say you don't need to wait for the bone to heal before starting gentle back exercises. Build up strength once it has healed, ideally with a physiotherapist's advice, as your team allows.

What exercises should I avoid with a compression fracture?

Modify deep, repeated or loaded rounding of the back: sit-ups, toe touches, Pilates roll-downs and lifting with a rounded back. Keep impact to brisk walking, and avoid heavy lifting and repeated bending in the first weeks. Bending forward in everyday life is generally safe.

Is walking good for compression fractures?

Yes. Short walks as pain allows, building to about 20 minutes a day, are recommended after a spinal fracture. Staying active also lowers the risk of chest infections, constipation and blood clots.

Should I wear a back brace?

Routine bracing isn't recommended in the UK. A large trial found a rigid brace no better than a soft one, and pooled trials found a rigid brace eased pain for a few months without changing anything else. If your team offers one for comfort, follow their advice.

Do vertebroplasty or kyphoplasty work?

Vertebroplasty did no better than a sham procedure in high-quality trials. NICE allows either procedure only for severe, ongoing pain from a recent, unhealed fracture despite the best pain relief, and neither strengthens your bones or lowers the risk of another fracture.

Can a compression fracture cause paralysis?

The Royal Osteoporosis Society says osteoporotic spinal fractures are stable and don't cause paralysis. Very rarely a fracture presses on the nerves, so new numbness, weakness, or bladder or bowel changes need urgent help.

Will I break another bone?

The risk is raised: about 1 in 5 women had another spinal fracture within a year of a new one. Bone medicines cut new spinal fractures by 40% to 70%, so ask about a bone health check.

Why have I lost height, and can exercise straighten my back?

Healed spinal bones keep their squashed shape, and several fractures can cause height loss and an outward curve of the upper back. Exercises may help with pain, posture and strength, but they can't reverse a curve caused by fractures. The kyphosis guide has more on the curve.

What is the best sleeping position with a compression fracture?

A pillow under your knees if you lie on your back, or between your knees if you lie on your side, can ease the pain. Turn over slowly.

What helps the pain?

Enough pain relief to keep you moving, plus heat, cold and relaxation. UK guidance advises avoiding anti-inflammatory painkillers in older people, or protecting the stomach if they're used, so ask your GP or pharmacist what suits you.

Do I need a bone density scan?

NICE offers a bone density scan to people who have had a spinal fragility fracture, and suggests considering bone medicine. Ask your GP; many areas have a fracture liaison service.

Related exercise guides

Kyphosis guide

Other pain guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.