Differential Diagnosis: Back pain and Osteoporosis

  • Kristina Åkesson
  • Anthony D. Woolf


  • Vertebral fracture due to underlying osteoporosis is an important cause of back pain. Other reasons for fracture should always be excluded.

  • Vertebral osteoporosis presents clinically in only about 30% of affected people and is more often an incidental finding, despite being associated with disability. The impact increases with increasing number of vertebral fractures and severity of spinal deformity. Vertebral osteoporosis is associated with increased risk of further fracture and excess mortality. Comorbidity worsens the outcome.

  • Management involves trying to achieve pain control, restoring activities through rehabilitation, and interventions to reduce risk of further fracture.


Back Pain Vertebral Fracture Bone Scintigraphy Vertebral Deformity Chronic Back Pain 


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Further Reading

  1. O’Neill TW, Felsenberg D, Varlow J, et al. (1996) The prevalence of vertebral deformity in Europe an men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res 11: 1010–1018.Google Scholar
  2. Nevitt MC, Ettinger B, Black DM, et al. (1998) The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Ann Intern Med 128: 793–800.Google Scholar
  3. Lips P, Cooper C, Agnusdei F, et al. (1999) Quality of life in patients with vertebral fractures: validation of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Osteoporos Int 10: 150–160.Google Scholar
  4. Oleksik A, Lips P, Dawson A, Minshall ME, et al. (2000) Health-related quality of life in postmenopausal women with a low BMD with or without prevalent vertebral fractures. J Bone Miner Res 15: 1384–1392.Google Scholar
  5. Ross PD (1997) Clinical consequences of vertebral fractures. Am J Med 103: 30–435.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2004

Authors and Affiliations

  • Kristina Åkesson
  • Anthony D. Woolf

There are no affiliations available

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