Back Pain and Osteoporosis

A number of different conditions can cause back pain, but one in particular is often overlooked. For millions of Americans the cause of their back pain is osteoporosis.

Osteoporosis is a disease in which bones become fragile and more likely to break. Like back pain, osteoporosis can be disabling. But unlike back pain, osteoporosis is "silent," with typically no signs or symptoms until the disease is in advanced stages.

The danger is that spinal fractures and compressions resulting from osteoporosis can often happen with minimal trauma and patients can mistake their discomfort for chronic back pain.

"People with back pain think, like their friends, they have arthritis. But in actuality they may have osteoporosis, and have had a fracture in their back," says Linda Russell, MD, specialist in the treatment of osteoporosis at the Hospital for Special Surgery in New York.

The treatment of osteoporosis and osteoarthritis is different, she says, so it is very important to make the distinction.

Who is at Risk?

According to the National Osteoporosis Foundation, the following factors raise the risk of osteoporosis:

  • Being female
  • Older age
  • Family history of osteoporosis or broken bones
  • Being excessively thin
  • History of broken bones
  • Low estrogen levels in women, including menopause
  • Missing periods (amenorrhea)
  • Low levels of testosterone and estrogen in men
  • Low calcium intake
  • Low vitamin D intake
  • Excessive intake of protein, sodium and caffeine
  • Inactive lifestyle
  • Smoking
  • Alcohol abuse
  • Certain medications such as steroid medications, some anticonvulsants and others
  • Certain diseases and conditions such as anorexia nervosa, rheumatoid arthritis, gastrointestinal diseases and others

Diagnosing Osteoporosis

Doctors commonly diagnose osteoporosis by measuring bone density.

The National Osteoporosis Foundation recommends a bone density test if you are:

  • A woman older than age 65 or a man older than age 70, regardless of risk factors
  • A postmenopausal woman with at least one risk factor for osteoporosis
  • A man between age 50 and 70 who has at least one osteoporosis risk factor
  • Older than age 50 with a history of a broken bone
  • Taking medications, such as prednisone, aromatase inhibitors or anti-seizure drugs (associated with osteoporosis)
  • A postmenopausal woman who has recently stopped taking hormone therapy.
  • A woman who experienced early menopause

How to Lower Your Risk for Osteoporosis

Increase your calcium intake. Research has shown that low calcium intake contributes to diminished bone density, early bone loss, and an increased risk of fractures. Dairy products are a good source of calcium, as well as almonds, broccoli, spinach, kale, sardines, and soy products such as tofu.

Increase your intake of vitamin D. Getting enough vitamin D is considered just as important to your bone health as getting adequate amounts of calcium. Good sources of vitamin D are sunlight, tuna, sardines, and egg yolks. If you don't eat these things regularly, you may want to consider a supplement. Talk to your doctor about recommended dosage.

Eat healthy meals. According to the Mayo Clinic, women and men with anorexia nervosa or bulimia are at higher risk of lower bone density.

Get Regular Exercise. Research has shown that people who spend a lot of time sitting have a higher risk of osteoporosis than their more-active counterparts. Try walking, running, swimming, dancing or strength-training for 30 minutes 3-5 times per week.

Quit smoking. Studies have shown that tobacco use contributes to weak bones.

Reduce your alcohol consumption. Regular consumption of more than two alcoholic drinks a day increases your risk of osteoporosis. This is thought to be because alcohol can interfere with the body's ability to absorb calcium.

Talk to your doctor about long-term use of any medication. Certain medications are damaging to the bone and increase bone loss. Make sure to talk to your doctor about alternatives.

If you are experiencing chronic back pain and are at risk for osteoporosis, contact your doctor to request a bone density test.


Back Pain and Osteoporosis Special Report. 6 Exercises to Help Build Bone Strength and Prevent Osteoporosis. John Hopkins Medicine. Accessed January 29, 2010.

Back Pain and Osteoporosis. John Hopkins Medicine. Accessed January 29, 2010.

Mayo Clinic Staff. Osteoporosis, Information Page. Accessed January 29, 2010.

Osteoporosis: A debilitating disease that can be prevented and treated. National Osteoporosis Foundation. Accessed January 31, 2010.

When is Back Pain Osteoporosis? NBC Digital Health Network. Accessed January 29, 2010.