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Acute fractures will cause severe back pain. Compression fractures which develop gradually, such as in osteoporosis, may initially not cause any symptoms, but will later often lead to back pain and loss of height. [citation needed]
Symptoms suggestive of cord compression are back pain, a dermatome of increased sensation, paralysis of limbs below the level of compression, decreased sensation below the level of compression, urinary and fecal incontinence and/or urinary retention. Lhermitte's sign (intermittent shooting electrical sensation) and hyperreflexia may be present.
Compression at the superior cervical region can lead to compensatory compression at inferior levels (for example, the lumbar spine) and affect control over bowel or bladder function. [4] The severity of such symptoms tend to progress over time and occur more frequently amongst older patients. [5]
A compression fracture of the vertebra can also cause acute and/or chronic pain in the upper back. Trauma may cause a fracture, but in women over age 50 without significant trauma or someone known to have osteoporosis, a spontaneous vertebral compression fracture is possible. [4]
Common causes of vertebral fractures include trauma from a direct blow, a compression force resulting in improper or excessive axial loading, and hyper-flexion or hyper-extension. [ 10 ] Vertebral fractures in children or elderly individuals can be related to the development or health of their spine.
Lumbar disc herniations occur in the back, most often between the fourth and fifth lumbar vertebral bodies or between the fifth and the sacrum. Here, symptoms can be felt in the lower back, buttocks, thigh, anal/genital region (via the perineal nerve), and may radiate into the foot and/or toe.
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