A lumbar fracture is a break in one or more of the five vertebrae forming the lower part of the spine. Injuries range from relatively stable compression fractures to more complex fractures that may affect spinal stability or the nerves within the spinal canal. The severity of the injury, neurological findings and associated injuries all influence treatment and recovery.
Persistent pain, reduced mobility, spinal deformity, neurological impairment, deconditioning and complications following surgery
Lower-back pain, tenderness, muscle spasm and difficulty standing, walking or changing position; neurological symptoms may occur with more severe injuries
Clinical and neurological assessment with X-rays and/or CT; MRI may be required where ligament, spinal cord or nerve injury is suspected
Pain relief and progressive mobilisation, sometimes with spinal bracing; surgical stabilisation or decompression for selected injuries
Progressive mobility, physiotherapy, strengthening, functional rehabilitation and graded return to daily activities and work
Initial fracture healing commonly progresses over approximately 8–12 weeks, with functional improvement continuing for several months
Persistent pain, reduced mobility, spinal deformity, neurological impairment, deconditioning and complications following surgery
Recovery from a lumbar fracture depends on both fracture healing and restoration of function. Once the spine is sufficiently stable, appropriate mobilisation and progressive rehabilitation are important for rebuilding movement, strength and confidence while limiting the effects of prolonged inactivity.
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Pain management, neurological monitoring, fracture protection and safe mobilisation when appropriate
Progressive walking and everyday activity; brace management where prescribed; maintaining general mobility and conditioning
Progression of fracture healing; increasing movement, daily activity and appropriate strengthening
Improving trunk and lower-limb strength, endurance and confidence; progressive return towards usual work and recreation
Continued higher-level functional recovery; reassessment and management of persistent pain, weakness or functional limitations where required
Bone healing and functional recovery do not necessarily progress at the same rate. Strength, endurance and confidence may continue improving after the fracture itself has healed.
Initial bone healing commonly progresses over approximately 8–12 weeks, although this varies with fracture severity and individual health. Strength, endurance and functional recovery may continue improving for several months.
Many stable fractures without neurological impairment can be managed without surgery. Surgery is more likely where the fracture causes significant instability, deformity or neurological compromise.
Not necessarily. Bracing may be used for selected fractures, but evidence does not support its routine use for every stable lumbar fracture. Follow the advice of the treating spinal team.
Many people benefit from physiotherapy, particularly where pain, weakness or reduced mobility restrict normal function. Rehabilitation is progressively adapted as healing and physical capacity improve.
There is no universal timetable. Driving should resume when you can safely enter and exit the vehicle, sit comfortably, control the vehicle fully and perform an emergency stop without significant pain or restriction, subject to relevant medical and insurer advice.
This depends on the fracture and your occupation. Sedentary or modified duties may be possible earlier, while heavy manual work generally requires greater healing, strength and functional recovery.
Walking and appropriate general activity commonly form part of rehabilitation once mobilisation is permitted. More demanding exercise and spinal loading should be introduced progressively according to healing, symptoms and clinical guidance.
Lumbar fracture is also commonly referred to as lower back fracture, lumbar spine fracture, fractured lumbar vertebra, broken vertebra or lower spine fracture.
Successful recovery from a lumbar fracture should be judged by restoration of meaningful function rather than fracture healing alone. Once appropriate spinal stability has been achieved, progressive rehabilitation helps restore mobility, strength, endurance and confidence.
Where recovery plateaus, reassessment should consider persistent pain, neurological symptoms, physical deconditioning, fear of movement, psychological factors and occupational barriers. Identifying these factors allows rehabilitation to be adjusted to the individual’s needs and supports the best achievable return to independence, work and recreation.
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People interested in this injury also find the following related rehabilitation guides useful:
You may also wish to explore some of the organisations and publications that informed this guide.