ABSTRACT
Back pain [BP] is a common symptom among the general population,particularly in the elderly subjects. It is the most common feature of osteoporosis [OP] as well as a symptom of vertebral fracture [VF]. In elderly women it may be a heralding symptom of OP and possibly a presenting feature of VF. The present study was designed to determine the frequency of low bone mass in postmenopausal women presenting with BP. 155 postmenopausal women with BP were studied. Bone mineral density [BMD] was measured with use of dual energy x-ray absorptiometry [DXA] with a single Norland Excell densitometer. BMD was determined in the femoral neck [FN] and L2-L4 region of lumbar spine [LS]. T-score and Z-score at both regions were determined. Frequency of OP and osteopenia at the FN and LS regions were detrmined according to WHO criteria. Patients with inflammatory musculoskeletal diseases, inflammatory back pain, infectious, or malignant spinal diseases, and history of rheumatic diseases or spinal surgery were excluded. Chi square and t tests were used for comparisons. The mean age and the mean menopausal duration of patients were 64 +/- 8 and 16 +/- 9 years respectively. Sixty-three percent of patients were 60 years or over. The mean BMD at the LS and FN were 0.70 +/- 0.13 gr/cm-2 and 0.79 +/- 0.18 gr/cm-2 respectively. The proportion of OP at the FN and LS were 30% and 56% respectively. The combined prevalence of OP at both FN and LS was 61.5%. The proportion of patients with Z-score<-1 and<-2 at the LS were 40% and 22% and at the FN were 37% and 11% respectively. In patients, aged 70 years and over, compared with patients below 70 years the BMD was decreased by 14% at the FN and 10% at the LS [P<0.02 and P<0.001 respectively]. Menopausal duration of over than 10 years was associated with 5.6 fold risk of OP. The results of this study indicate that, the majority of postmenopausal women with BP are osteoporotic or osteopenic at the LS or FN. So they are at increased risk of future vertebral or femoral neck fractures