Friday, 23 Mar 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

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. 


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

Add new comment

More Like This

Novel Approach to Knee Osteoarthritis Pain

Geniculate artery embolization was found to dampen knee pain arising from osteoarthritis, according to interim study results presented at the 2018 annual meeting of the Society of Interventional Radiology.

One month after the catheter-based procedure, patients reported having less intense knee pain on a visual analog scale (VAS; baseline 75 mm, average decrease of 53 mm, P<0.01).

Limited Utility of Arthroscopic Meniscal Surgery

JAMA Surgery reports that arthroscopic partial meniscectomy (APM) is still one of the most common surgeries performed, despite evidence from large trials (eg, FIDELITY study) showing that APM is no more effective than exercise and physical therapy, especially in adults over age 65 years.

Hip Replacement Augments Longevity

Data from Swedish hip replacement registry finds that total hip arthroplasty not only improves quality of life, it is also associated with increased life expectancy that lasts for 10 years after surgery, especially in primary osteoarthritis patients.

HERO Trial - Hydroxychloroquine Fails in Hand Osteoarthritis

UK researchers have treated 248 patients with moderate to severe hand pain and radiographic osteoarthritis (OA) and demonstrated no benefit after 12 months of hydroxychloroquine (HCQ), according to a recent article in Annals of Internal Medicine.

Teriparatide Superior to Risedronate in the VERO Trial

Lancet reports that in a study teriparatide with risedronate, post-menopausal women with severe osteoporosis had significantly fewer new vertebral and clinical fractures on teriparatide comared to those receiving risedronate.

This trial is one of the first to compare osteoporosis drugs with incident fractures as the primary outcome.