Felicia Cosman MD, Linda Russell MD, Danielle Petersel MD
Back pain is a common condition that many people don't
take very seriously. But in some cases, back pain is just a surface
symptom of a much deeper problem: osteoporosis. Unfortunately, even some
doctors have a hard time telling the difference. When should you be
worried and what can you do to make sure you are diagnosed
ANNOUNCER: A number of different conditions
can cause back pain, but one is often overlooked. For millions of peole,
chronic back pain is the result of osteoporosis.
WOMAN: I had no idea that certain pains are related --
back pain is related to osteoporosis.
2: I didn't know that osteoporosis could be related to
FELICIA COSMAN, MD: Sometimes
people who have back pain, have it as a result of osteoporosis. However,
the bone loss itself does not produce back pain. A person who has back
pain with osteoporosis will also have a fracture of the spine or
compression of the spine as a cause of the back pain.
ANNOUNCER: Because osteoporosis is a silent disease
where bone loss may occur for years without any signals, the danger is
that often spinal fractures and compressions occur with minimal trauma.
That's when patients can mistake their discomfort for chronic back
LINDA RUSSELL, MD: People will have
back pain and think, just like their friends, they have arthritis. But in
actuality they may have osteoporosis, have had a fracture in the back and
the only way to make that diagnosis would be with either an X-Ray, an MRI
or a CAT-scan. That would confirm that they've actually had a
fracture. And a bone density would confirm that they have osteoporosis and
they you'd be able to make the entire diagnosis for them. The
treatment of osteoarthritis and osteoporosis is different so it's
very important to make the distinction.
ANNOUNCER: But unless a fracture is the result of
serious trauma, doctors and patients often fail to pinpoint the problem.
LINDA RUSSELL, MD: The problem is that many
patients could have had a fracture without any trauma and with no pain. So
there are patients who in the past may have had an undiagnosed fracture
both to the doctor and to the patient.
MD: Misdiagnosis is a problem in osteoporosis but more important
I think is a just a lack of diagnosis. Many times a doctor who is treating
a woman for a fracture takes care of the fracture and never goes beyond
It should be that every single person who has a
fracture in adulthood in the absence of some major trauma, like a motor
vehicle accident, gets evaluated for osteoporosis.
ANNOUNCER: Especially if a patient falls into a
WOMAN 3: I'm just
very sensitive to having a history of back pain. I just know how
debilitating it can be.
FELICIA COSMAN, MD:
Well, we know that people as they age, both women and men are at risk for
osteoporosis and in addition, all women at the time of menopause are at
risk. We know that at menopause women lose a large percentage of their
bone mass. And if they start out at a low bone mass, that is that they
have a low peak bone mass, and then lose a lot of bone at menopause,
they're going to be in trouble at that stage in their lives, and
ANNOUNCER: Dr. Cosman recommends
that everyone should optimize their health with adequate calcium and
vitamin D intake and exercise. She urges patients to consult their
FELICIA COSMAN, MD: Patients should
ask their doctor about the need for a bone density test if a fracture
ANNOUNCER: But she also warns that
examining physicians need to be more vigilant in identifying osteoporosis.