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When is Back Pain Osteoporosis?

Summary & Participants

Back pain is a common condition that many people don't take very seriously. But in some cases, back pain is just a surface symptom of a much deeper problem: osteoporosis. Unfortunately, even some doctors have a hard time telling the difference. When should you be worried and what can you do to make sure you are diagnosed correctly?

Medically Reviewed On: March 09, 2006

Webcast Transcript

ANNOUNCER: A number of different conditions can cause back pain, but one is often overlooked. For millions of peole, chronic back pain is the result of osteoporosis.

WOMAN: I had no idea that certain pains are related -- back pain is related to osteoporosis.

WOMAN 2: I didn't know that osteoporosis could be related to back pain.

FELICIA COSMAN, MD: Sometimes people who have back pain, have it as a result of osteoporosis. However, the bone loss itself does not produce back pain. A person who has back pain with osteoporosis will also have a fracture of the spine or compression of the spine as a cause of the back pain.

ANNOUNCER: Because osteoporosis is a silent disease where bone loss may occur for years without any signals, the danger is that often spinal fractures and compressions occur with minimal trauma. That's when patients can mistake their discomfort for chronic back pain.

LINDA RUSSELL, MD: People will have back pain and think, just like their friends, they have arthritis. But in actuality they may have osteoporosis, have had a fracture in the back and the only way to make that diagnosis would be with either an X-Ray, an MRI or a CAT-scan. That would confirm that they've actually had a fracture. And a bone density would confirm that they have osteoporosis and they you'd be able to make the entire diagnosis for them. The treatment of osteoarthritis and osteoporosis is different so it's very important to make the distinction.

ANNOUNCER: But unless a fracture is the result of serious trauma, doctors and patients often fail to pinpoint the problem.

LINDA RUSSELL, MD: The problem is that many patients could have had a fracture without any trauma and with no pain. So there are patients who in the past may have had an undiagnosed fracture both to the doctor and to the patient.

FELICIA COSMAN, MD: Misdiagnosis is a problem in osteoporosis but more important I think is a just a lack of diagnosis. Many times a doctor who is treating a woman for a fracture takes care of the fracture and never goes beyond that point.

It should be that every single person who has a fracture in adulthood in the absence of some major trauma, like a motor vehicle accident, gets evaluated for osteoporosis.

ANNOUNCER: Especially if a patient falls into a high-risk category.

WOMAN 3: I'm just very sensitive to having a history of back pain. I just know how debilitating it can be.

FELICIA COSMAN, MD: Well, we know that people as they age, both women and men are at risk for osteoporosis and in addition, all women at the time of menopause are at risk. We know that at menopause women lose a large percentage of their bone mass. And if they start out at a low bone mass, that is that they have a low peak bone mass, and then lose a lot of bone at menopause, they're going to be in trouble at that stage in their lives, and thereafter.

ANNOUNCER: Dr. Cosman recommends that everyone should optimize their health with adequate calcium and vitamin D intake and exercise. She urges patients to consult their doctors.

FELICIA COSMAN, MD: Patients should ask their doctor about the need for a bone density test if a fracture occurs.

ANNOUNCER: But she also warns that examining physicians need to be more vigilant in identifying osteoporosis.

FELICIA COSMAN, MD: I think that we need to make more efforts to educate doctors, both orthopedists and generalists, to look further beyond the actual fracture, to make sure that both doctors and patients are aware that osteoporosis is extremely prevalent and it's a very likely diagnosis in any person who has one of these fractures.