Can Osteoporosis Cause A Backache
David G. Borenstein, MD
David G. Borenstein, MD, clinical professor of medicine, division of rheumatology, The George Washington University Medical Center, Washington, DC. He is managing editor of The Spine Community website and author of Heal Your Back: Your Complete Prescription for Preventing, Treating and Eliminating Back Pain.
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Low Bone Mass Osteoporosis And Back Pain
Is there a connection between having ostepenia or osteoporosis and having pain back pain? If you look through the medical literature and do a few Google searches, you will find that the standard answer is there is no association. Low bone mass does not cause pain. Osteoporosis has always been characterized as a silent disease. That is, you will not have any symptoms until you break something! Anecdotally, through the years I have heard a number of different practitioners say that osteoporosis really can cause pain even if there is no apparent break or fracture. To this, I have seen a number of patients who we have treated for complaints of back pain and have referred them to a rheumatologist to work-up and treat their underlying osteoporosis issues. Several of these patients have come back in follow-up to say their back pain got significantly better after they received treatment for low bone mass. Is this coincidence or is there more to this?
I will say that there is not much in the literature about the association between low bone mass and back pain specifically. Interestingly, I have come across two types of studies that may help answer if an association exists. One of the studies, published in 2012 out of Amsterdam found an association between low bone mass and low back pain in 30 to 40 year old males. Another, more recent retrospective study showed an association of low bone mineral density and chronic low back pain in one population .
Osteoporosis Medications That Can Lead To Fatigue
Osteoporosis occurs when the body loses too much bone mass, or doesnt build new bone fast enough, increasing the risk of fractures. Some medications prescribed to promote bone health and bone density can cause side effects that may disturb sleep and promote fatigue.
Many MyOsteoTeam members taking Prolia , an osteoporosis drug given to postmenopausal women with a high risk of bone fractures, reported frequent nocturnal trips to the bathroom. Every night I wake up, sometimes four times, because I need to pee, said one member.
Another woman taking Forteo , a drug that increases bone density and bone strength, got nighttime cramps. Others reported general fatigue from Tymlos . When I was on that therapy for a year, the fatigue doubled, said one member of MyOsteoTeam.
If you suspect your fatigue may be related to a medication prescribed for osteoporosis, talk to your doctor. They can help identify the source of the fatigue and manage any side effects related to osteoporosis medications.
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What Are The Symptoms Of Osteoporosis
Unfortunately, the reason osteoporosis is called the silent disease is that it has no physical symptoms in its early stages. As the condition progresses, the following symptoms that indicate weakening bones may occur
- Lower back or neck pain
- Bone pain or tenderness
- Curved backbone or stooped posture
- Gradual loss of height
- Fractures from minor trauma, especially in the hip, spine or wrists
Pay Attention To Your Body Mechanics And Posture
Body mechanics are the way you use your body. Posture is the way you sit or stand.
- To prevent a return of low back pain, you will need to take extra care when you lift. When you must lift, bend your knees and flex from your hips. Don’t let your spine slump.
- Back Problems: Proper Lifting
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Can Lower Back Pain Be Related To Weather
If you feel like your lower back pain worsens on days when its cold or the weather is changing, you are not imagining things. Back pain can indeed be related to barometric pressure and outdoor temperature. Changes in pressure can sometimes cause pain in arthritic joints, including the spine. Muscles and joints in general react to the environment, which can make them stiffer and more likely to suffer an injury.
What Can You Do If You Are Living With Osteoporosis
If you have osteoporosis, you should continue with the lifestyle measures mentioned earlier in terms of eating well, getting enough exercise, avoiding excessive caffeine and alcohol consumption, and not smoking. Make sure that you follow the suggestions of your healthcare provider.You should do all that you can to prevent falls inside and outside of your home. You might want to start with a medical evaluation, which could lead to your healthcare provider providing assistive devices.
Prevent falls inside your home
- Keep your floors free of clutter, including throw rugs and loose wires and cords. Use only non-skid items if you have mats, carpets or area rugs.
- Make sure your lighting is bright enough so that you can see well.
- Do not use cleaners that leave your floors slippery.
- Clean up any spills that happen immediately.
- Use grab bars in the bathroom and railings on stairways.
Prevent falls outside your home
- Make sure lighting is adequate in all areas outside your home.
- Use a backpack or other type of bag that leaves your hands free.
- Keep areas outside in good repair and free of clutter.
- Wear sensible shoes with non-slip bottoms.
This is in no way a complete list of things that you can do to help prevent falls, but this is a starting point. Also remember to take your time. You might be less careful if you are in a hurry.
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What You Need To Know About Osteoporosis
Osteoporosis is a condition of low bone density and structural deterioration of bone tissue that causes an increased risk of fractures. Osteoporosis on its own does not cause pain or obvious symptoms. Complications from the condition, including vertebral fractures, may result in back pain and limited mobility.
Osteoporosis can lead to vertebral compression fractures injuries that occur when bone tissue inside the vertebrae of the spine breaks and then collapses. ReadOsteoporosis: The Primary Cause of Collapsed Vertebrae
More Osteoporosis Info
To catch osteoporosis early, as well as to identify those at risk of fractures caused by the condition, screening for risk factors is advised on the basis of age and sex. If screening identifies a relatively high risk for osteoporosis, a bone density test may be ordered.
In general, all women over age 65 and younger postmenopausal women with risk factors should be screened for low bone density. Some recommendations call for women to be screened as early as age 50.1 While there is no official recommendation in the U.S. for men, who are less at risk, it is generally advised that men over 70 are screened.1
The process of bone growth is called remodeling. Bone remodeling consists of the following:
Osteoporosis And Fatigue: Causes And Tips For Management
If you live with fatigue and osteoporosis, your fatigue may be related to side effects of medication, an underlying health condition, or simply a lack of vitamin D not the bone disease itself. Some members of MyOsteoTeam who say theyre tired all the time have also been diagnosed with arthritis, chronic fatigue, underactive thyroid, sleep apnea, and other medical conditions that can cause fatigue.
No matter the root cause, fatigue is a common experience among MyOsteoTeam members. Even after a good nights sleep, Im falling asleep in my chair at 11 a.m., said one member. By 12 noon, I’m so tired, I’ve got to take a nap just to make it to dinner, shared another member.
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Eat Healthy And Quit Bad Habits
Everyone needs to get plenty of calcium for bone health. If you have osteoporosis or low bone mass, your doctor might also recommend calcium supplements. In addition, it is important to get plenty of vitamin D, which helps the body absorb calcium into the bones.
See Food for Thought: Diet and Nutrition for a Healthy Back
Signs And Symptoms Of Early
Early, detectable signs of bone loss are rare. Often people dont know they have weak bones until theyve broken their hip, wrist, or some other bone.
However, some signs and symptoms can point toward potential bone loss, such as:
- Receding gums. Your gums can recede if your jaw is losing bone. Ask your dentist to screen for bone loss in the jaw.
- Weaker grip strength. In a study of postmenopausal women and overall bone mineral density, researchers found that low handgrip strength was linked to low bone mineral density. In addition, lower grip strength can increase your risk for falls.
- Weak and brittle fingernails. Nail strength can signal bone health. But you should also take other factors into consideration that may affect your nails, such as exposure to very hot or cold temperatures, regular use of nail polish remover or acrylic nails, or submersion in water for long periods of time.
Other than changes in bone density, osteoporosis doesnt usually cause a lot of initial symptoms. Your best bet for detecting it in the early stages is to talk with your doctor or healthcare professional, especially if you have a family history of osteoporosis.
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Osteoporosis And Non Specific Chronic Low Back Pain: Correlation With Sex And Severity Of Backache
More than 80% of adults have Low Back Pain at some time in their life. Most of the time, the exact cause of the pain cannot be found and this is called as nonspecific LBP. Relationship between OP and nonspecific chronic LBP are not clear. The aim of this study was to evaluate the association between OP and non specific chronic LBP and correlation with sex and severity of backache. One hundred patients with non specific chronic LBP and another 100 control persons without LBP were studied by DEXA and lumbosacral MRI. By DEXA 28 of patients and 15 of control having OP but by MRI 21 of patients and 10 of control having signs of OP, with significant difference between both groups . No significant difference between OP and severity of backache was observed. As regard to sex 30 from the cases that having OP were females, while 13 from this cases were males with significant difference between them . The OP is a considerable finding in non specific chronic LBP, accounting . Most cases with OP were females and no significant difference between OP and severity of backache was found. So, it was recommended that every case of non specific chronic LBP to be evaluated by DEXA.
|Howto cite this article:Saad M. Alzokm, Aly R. Ebraheim, Tarek A. Nasrallah and Mostafa Shakweer, 2015. Osteoporosis and Non Specific Chronic Low Back Pain: Correlation with Sex and Severity of Backache. International Journal of Osteoporosis and Metabolic Disorders, 8: 10-18.|
How Is Low Back Pain Diagnosed
Your doctor will ask questions about your past health, symptoms, and activities. He or she will also do a physical examination. Your answers and the examination can help rule out a serious cause for the pain. In most cases, doctors are able to recommend treatment after the first examination.
Tests such as X-rays, CT scans, and MRIs usually don’t help.
But if you have a back pain problem that has lasted longer than 6 weeks, or if your doctor thinks you may have more than muscle pain, it might be time for one of these tests.
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When Surgery Is Necessary
When conservative treatment for low back pain does not provide relief or neurologic symptoms are worsening or severe, surgery may be needed. Candidates for surgery present any of the following:
- Reasonably good health
- Back and leg pain limits normal activity or impairs quality of life
- Progressive neurologic deficits develop, such as leg weakness, numbness or both
- Loss of normal bowel and bladder functions
- Difficulty standing or walking
- Medication and physical therapy are ineffective
If surgery is recommended, neurosurgeons have a variety of options available to help relieve pressure on the nerve roots. If several nerve roots and discs are causing the pain or if degeneration and instability exist in the spinal column, the neurosurgeon may choose: a minimally invasive approach a more open decompression or fusing the vertebrae together with bone grafts and stabilizing them with instrumentation, including metal plates, screws, rods and cages, depending on the extent of disease. After such surgery, patients may gain restored mobility in the back, including the ability to bend over. In addition, patients may require postoperative physical therapy.
The benefits of surgery should always be weighed carefully against the risks. Although a large percentage of patients with low back pain report significant pain relief after surgery, it is not guaranteed that surgery will help.
Kyphosis And Bone Breaks In The Spine
The bones in the spine are called vertebrae. When they break, they are called vertebral fractures or compression fractures. Breaking one or more bones in the spine can cause sharp back pain that does not go away, or there can be no pain at all. After having several of these breaks, people may start to have a curved spine and lose height. When there is no pain, many people do not know they have broken a bone in the spine. After becoming shorter by an inch or more in one years time, some people realize there is a problem with the spine. Because of height loss and changes in the spine, clothes may start to fit poorly.
The curve in the spine or the backbone that causes it to curve forward and look stopped or hunched is called kyphosis. As more bones break in the spine, the spine becomes more curved. When it is severe, kyphosis is sometimes called a dowagers hump. Other conditions, besides broken bones in the spine, can also cause kyphosis.
For some people, kyphosis causes constant pain. This pain happens when the spine becomes more curved and the muscles, tendons and ligaments of the back are strained and stretched. Sometimes nerves are also pinched.
Severe kyphosis can reduce the space for internal organs. It may also cause the stomach or abdomen to push forward and appear to stick out. As a result, it is harder for some people to breathe or eat, and they may not get enough food and nutrition for their health.
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Coping With Chronic Back Pain
Low back pain can take a toll on your mental health. You may feel fear, frustration, and anger or have depression and anxiety because of ongoing pain. Those common reactions can make your pain last even longer. If pain is starting to get you down:
- Let people know when you need a helping hand. Ask family members or friends to help out with physical tasks you can’t do right now.
- Be honest with your doctor about your pain. Ask for a referral to a counsellor or pain management specialist. A prescription antidepressant or antianxiety medicine may also help with chronic pain.
- Work with your health professionals and your work supervisor to make a return-to-work plan, if needed. Ask for an ergonomic consultation if you need to learn how to do some of your job duties differently to avoid hurting your back again.
One Man’s Story:
“I started feeling sad and angry a lot. I didn’t want to do anything. My back was hurting more. I was having trouble focusing on my work. My life just started feeling smaller and smaller.”â Ravi
Read more about how Ravi learned he had depression and how he fought back.
Back Sprain Or Strain
Symptoms typically include:
- Muscle spasms, cramping, and stiffness.
- Pain in the back and sometimes in the buttock. It may come on quickly or gradually. It most often occurs in episodes. Certain movements make it worse, and doing light activities such as walking makes it feel better. The worst pain usually lasts 48 to 72 hours and may be followed by days or weeks of less severe pain.
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Other Medications That Can Cause Fatigue
Fatigue can also be a side effect of drugs prescribed for other common medical conditions affecting postmenopausal women. Medications that treat heart problems, for example, can cause sleeplessness. So can some antidepressants, thyroid medications, and decongestants, according to the National Sleep Foundation. Some drugs may contain stimulants, including medications for asthma, smoking cessation, and pain. Ive been getting a good nights sleep since being off strong painkillers, shared one member of MyOsteoTeam.
Long-term use of oral or injected steroids, such as Prednisone and Cortisone, are also known to interfere with sleep. At the same time, they can worsen osteoporosis, causing a loss of 10 percent to 20 percent of bone mass within the first six months of corticosteroid therapy, according to the Hospital for Special Surgery.
One MyOsteoTeam member who has multiple autoimmune disorders said, Most of my medicines cause fatigue.
Many members of MyOsteoTeam who are fatigued agree that dealing with the daily pain associated with aging, arthritis, and related conditions zaps their energy. I’m exhausted every evening when the pain is at its worst and I cant sleep, said one member. Another agreed, Yes, pain is exhausting.
Poor eating habits, excess weight, lack of weight-bearing exercise, and other lifestyle issues also contribute to fatigue.