The patient with metabolic bone disease and low back pain

Abstract

In metabolic bone disease it is not only the bones of the vertebral column that are involved, but indeed all osseous structures throughout the body. Not infrequently, however, patients with metabolic bone disease present with back pain as their first complaint. At times symptoms are unspecific. Other times there are distinct features in the patient’s presentation that lead you to believe that a metabolic bone disease may be the cause of the patient’s problem. Those include extreme pain following a trivial trauma to the back, progressive kyphosis and/or scoliosis and previous distal radius and hip fractures (Table 1). Metabolic bone disease should always be suspected in elderly women with unspecific complaints and normal objective findings.