Men's Osteoporosis Support GroupPain location correlation to vertebral fracture Rheumatology (Oxford). 2009 Dec 16. [Epub ahead of print]. Lateral back pain identifies prevalent vertebral fractures in post-menopausal women: cross-sectional analysis of a primary care-based cohort. Clark EM and others. PMID: 20015975. Vertebral fractures (VFs) are often associated with osteoporosis, but are not recognized or diagnosed. VFs often cause pain, but back pain is also common in individuals without VFs. This study used a Margolis pain diagram, a blank outline of the front and back of a person, upon which to show the location of back pain. A total of 504 post-menopausal women with back pain that reported to a primary care clinic in the U.K. were enrolled in the study. Radiographs were used to diagnose VFs with a total of 37 (7.3%) of women having one or more VFs. The results showed, "In women with back pain, the presence of lateral waist area pain was associated with a 4.5-fold increased risk of VFs [odds ratio (OR) 4.48; 95% CI 2.02, 9.94; P < 0.001]." And the authors concluded, "In post-menopausal women with back pain, the presence of lateral waist pain, as shown on the Margolis pain diagram, may identify women at higher risk of prevalent VF." Editor's comments. This study showed that VF pain is not as likely to show up in the mid-back, rather laterally along the waist line. That doesn't necessarily mean that all VFs will present with lateral pain, just that lateral pain is more likely to be from a VF than normal lower back pain would be. This is important for the examining physician, or other healthcare provider, but also for the patient. If you have osteoporosis, don't ignore lateral waist pain. Instead see your care provider and have X-rays taken to rule out a VF. Additionally, if you have osteoporosis and you have mid-back pain, it would be more likely related to something else than your osteoporosis. This could be reassuring, but also might be something that requires therapy.
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