Bone Health and Back Pain: What Do We Know and Where Should We Go?

Overview

Journal Osteoporos Int

Specialties Endocrinology
Orthopedics

Date 2008 Aug 22

PMID 18716821

Citations 6

Authors

A M Briggs

L M Straker

J D Wark

Affiliations

Soon will be listed here.

Abstract

Bone health is generally not considered in patients who present with chronic back pain. Nonetheless, bone health and back pain share common genetic and environmental correlates suggesting a co-dependence. Evidence exists for a relationship between back pain and impaired bone health. Here we present the evidence, theoretic framework and clinical relevance. Bone health and back pain are important determinants of musculoskeletal health. Back pain experienced in youth is a risk factor for future back pain, while suboptimal bone health during development increases the risk of skeletal fragility in later life. Generally, bone health is not considered in patients with chronic back pain who do not demonstrate other well-recognised bone health risk factors or associated conditions. Nonetheless, evidence suggests that back pain and impaired bone health share common environmental and genetic correlates, indicating that bone health ought to be considered in the context of back pain in otherwise healthy individuals. This review describes the likely mechanisms explaining the relationship between back pain and impaired bone health, evidence concerning the relationship and suggestions for future research. A narrative literature search was conducted using CINAHL, Medline, PubMed and Web of Science electronic databases. A history of back pain is associated with decreased bone mineral density in adults, yet this tends to be site-specific. No studies were identified examining this association in youth, yet the negative effects of childhood skeletal trauma and obesity on bone and spinal health provide indirect evidence for an association. Further research is required to clarify the impact of back pain on bone health at different lifespan stages using prospective cohort designs.

Citing Articles

Does the risk of chronic low back pain depend on age at menarche or menopause? A population-based cross-sectional and cohort study: the Trøndelag Health Study.

Heuch I, Heuch I, Hagen K, Storheim K, Zwart J BMJ Open. 2022; 12(2):e055118.

PMID: 35210341 PMC: 8883263. DOI: 10.1136/bmjopen-2021-055118.

Pain and falls and fractures in community-dwelling older men.

Munch T, Harrison S, Barrett-Connor E, Lane N, Nevitt M, Schousboe J Age Ageing. 2015; 44(6):973-9.

PMID: 26396181 PMC: 4621231. DOI: 10.1093/ageing/afv125.

Vertebral bone mineral measures and psychological wellbeing among individuals with modic changes.

Briggs A, OSullivan P, Foulner D, Wark J Clin Med Insights Case Rep. 2012; 5:35-41.

PMID: 22493564 PMC: 3320114. DOI: 10.4137/CCRep.S9209.

Chronic low back pain is associated with reduced vertebral bone mineral measures in community-dwelling adults.

Briggs A, Straker L, Burnett A, Wark J BMC Musculoskelet Disord. 2012; 13:49.

PMID: 22458361 PMC: 3359205. DOI: 10.1186/1471-2474-13-49.

Bone mineral density, body mass index, postmenopausal period and outcomes of low back pain treatment in Korean postmenopausal women.

Park J, Shin J, Youn Y, Champagne C, Jin E, Hong S Eur Spine J. 2010; 19(11):1942-7.

PMID: 20811756 PMC: 2989254. DOI: 10.1007/s00586-010-1559-7.

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