Friday, 20 Jul 2018

You are here

Osteoporotic Fractures as Back Pain in Older Men

The Journal of Bone and Mineral Research reports that older men with undiagnosed vertebral fractures are likely to report new or worsening back pain. (Citation source bit.ly/2y9rMiZ)

They studied the frequency of clinically incident undiagnosed radiographic vertebral fractures and its association with back pain by examining data from 4396 elderly men enrolled in the U.S. Osteoporotic Fractures in Men study between 2000 and 2002.  They were assessed at baseline and 4.6 years later.

A total of 28 men were diagnosed with vertebral fractures by their own physicians during the follow-up. However, X-rays taken at the end of the study period showed an additional 169 men had new vertebral fractures that had not been diagnosed. Those with incident vertebral fractures were likely to have back pain, regardless of whether they had been diagnosed clinically or not.  This included any back pain (70% vs. 59%), severe back pain (8% vs. 4%), bothered by back pain most/all the time (22% vs. 13%) and limited usual activity from back pain (34% vs. 18%).

Men with clinically undetected fractures tended to be older, have poorer health status and often had a history of vertebral fractures.

These findings are similar to that seen in elderly women, albeit at a lower prevalence. This is consistent with findings that men have a lower prevalence of osteoporosis than elderly women.

Preventing these fractures may reduce back pain and related disability in older men. 

 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Update on Osteoporosis

This session was an update on the management of osteoporosis given by Professor Christian Roux from France.

He emphasised the use of composite risk score like the FRAX. He highlighted that the risk of vertebral fracture is increased by both the recency and severity of previous vertebral fracture. So it is important that those with vertebral fractures are followed up and treated appropriately to prevent subsequent fractures.

Restless Sleep and Inactivity Intertwined in OA

Adults with osteoarthritis (OA) of the knee who frequently experienced restless sleep were less likely to engage in potentially beneficial moderate-to-vigorous physical activity, analysis of data from the Osteoarthritis Initiative found.

FDA Approves Denosumab for Glucocorticoid-Induced Osteoporosis

Amgen announced that the U.S. Food and Drug Administration (FDA) has approved the use of Prolia® (denosumab) for the treatment of glucocorticoid-induced osteoporosis (GIOP) in men and women at high risk of fracture, defined as a history of osteoporotic fracture, multiple risk factors for fracture, or patients who have failed or are intolerant to other available osteoporosis therapy.

Bisphosphonate Drug Holidays May Result in Fractures

A report in Endocrine Practice shows that drug holidays from bisphosphonates results in a 15% risk of fractures.  (Citation source: http://bit.ly/2FHbFwp)

USPSTF Recommendations on Vitamin D, Calcium Supplementation to Prevent Fractures

The U.S. Preventive Services Task Force (USPSTF) concludes current scientific evidence is insufficient regarding the use of vitamin D and calcium, alone or in combination, to prevent fractures in men and premenopausal women. The USPSTF recommends against daily supplementation with 400 IU or less of vitamin D and 1,000 mg or less of calcium to prevent fractures in postmenopausal women. Current scientific evidence is insufficient regarding the use of vitamin D and calcium at doses greater than 400 IU of vitamin D and greater than 1,000 mg of calcium in postmenopausal women.