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Bone health

Vertebral fracture assessment

A low-dose spine image, usually added to a DEXA scan, that looks for silent compression fractures of the vertebrae.

Key facts

At a glance

  • Preparation: none beyond the standard DEXA advice; the assessment adds only a few minutes to the appointment.

  • On the day: the DEXA scanner takes a side-on image of your spine while you lie still - there is no extra visit and minimal extra radiation.

  • Why it matters: two-thirds of vertebral fractures cause no clear pain episode, yet each one sharply raises the risk of further fractures.

  • Results: reported alongside the bone density scores, typically within a few working days privately.

  • Follow-up: a confirmed vertebral fracture usually changes management - your GP or a metabolic bone specialist will discuss bone-protecting treatment.

The full picture

What this test involves, and how to get it

Vertebral fracture assessment (VFA) is a side-on image of the spine taken on a DEXA scanner, usually in the same appointment as a bone density measurement. Its purpose is to find compression fractures of the vertebrae that have happened silently: most cause no memorable injury, showing up only as gradual height loss or a curved upper back. Finding one matters because an existing vertebral fracture is one of the strongest predictors of future fractures, and it typically tips the balance in favour of treatment regardless of the T-score. The image adds a few minutes and a very small radiation dose.

On the NHS, VFA is added to DEXA scans where local protocols support it, particularly in people with height loss, back curvature or long steroid use. Privately, most bone density services can include VFA on request, with the combined report available within a few working days. If a fracture is found, a prompt review with your GP, a rheumatologist or an endocrinologist follows, and private appointments are typically available within one to two weeks if you prefer not to wait.

A quiet reminder

This guide is for information, not medical advice.

Your own clinician knows your history and can tell you which parts apply to you. Next review of this page: 2027-09-27.

Frequently asked

Common questions about Vertebral fracture assessment.

Quick, plain-English answers to what people ask us most.

  • What is Vertebral fracture assessment?

    Vertebral fracture assessment is a blood test that measures a specific substance or marker in your blood, giving your doctor useful information about how a particular system in your body is functioning. It is one of many tools used alongside your symptoms and history to build a fuller clinical picture. Your doctor can explain exactly why it is relevant in your case.

  • Why would a doctor order Vertebral fracture assessment?

    This test is typically requested to investigate specific symptoms, monitor an existing condition, or check for a deficiency or imbalance that could explain how you are feeling. It may also be used as part of a broader panel of related tests rather than in isolation. The result helps guide whether further tests, treatment, or simple monitoring is appropriate.

  • Do I need to prepare for this test?

    Some blood tests require fasting, a specific time of day, or pausing certain medications or supplements beforehand, while others need no special preparation at all. You will usually be told what applies to your specific test when it is booked. If you are unsure, it is worth checking with the clinic or lab in advance.

  • What happens during the test?

    A small blood sample is taken, usually from a vein in your arm, in a process that takes only a few minutes. It is generally straightforward and similar to any other routine blood draw. You can normally return to your usual activities straight afterwards.

  • Does this test hurt or carry any risks?

    A standard blood draw involves brief discomfort from the needle but is otherwise low-risk. Minor bruising at the site is the most common side effect and usually settles quickly. Let the person taking your sample know if you have a needle phobia or have had problems with blood tests before, as they can help make it more comfortable.

  • How long do results take?

    Results are typically available within a few days, though turnaround can vary depending on the specific test and laboratory used. You will usually be told when and how to expect your results at the time of testing. More specialised tests may occasionally take longer.

  • What do abnormal results mean, and what happens next?

    An abnormal result can have several possible explanations, from common and benign causes to conditions that need further assessment, and is best interpreted by a doctor alongside your symptoms and history. Depending on the finding, next steps might include repeating the test, further investigation, or referral to a specialist. Try not to draw firm conclusions from a number alone before speaking to a clinician.

  • Is this test available on the NHS, or is it better to go private?

    This test can often be arranged privately within days, with results reviewed by a specialist, whereas routine NHS access may depend on your GP agreeing it is clinically indicated and can involve a longer wait. Cost for private testing varies by provider. Many people choose the private route for speed and convenience, particularly if they are self-funding for reassurance rather than an urgent clinical concern.

  • Is this test accurate and reliable?

    Blood tests like this are well established and generally reliable when carried out by an accredited laboratory. Results can occasionally be affected by factors such as timing, recent illness, medication, or hydration, which is why doctors interpret a single result in context rather than in isolation. If a result seems unexpected, repeating the test is sometimes recommended.

  • How do I book this test privately, and how quickly can I be seen?

    You can typically book privately with or without a GP referral, and appointments, including blood draw and results review, are often available within a few days. A doctor will explain what your result means and advise on any next steps.