What is the relationship of low back pain to signs of abnormal skeletal metabolism detected by bone scans?
BACKGROUND
In approximately 80-85% of patients with chronic nonspecific low back pain (NSLBP), a precise pathoanatomical diagnosis cannot be identified. Mechanisms of bone nociception may contribute to NSLBP.


OBJECTIVE
To determine whether findings on bone scans, which provide a pathophysiological picture of functional activity, are associated with self-reports of NSLBP intensity.


METHODS
A cross-sectional study of the relationship of self-reported chronic NSLBP intensity to the uptake of radiolabeled technetium-99m-methylene diphosphonate in the lumbosacral area.


METHODS
Patients referred for bone scans who were at least 18 years old.


METHODS
Subject reports of pain intensity and intensity of uptake of radiolabeled technetium-99m-methylene diphosphonate in the lumbosacral area.


RESULTS
Among subjects who were 65 years or younger, the age-adjusted worst pain intensity accounted for 45% of the variability in the amount of tracer uptake (r = 0.67, P = 0.0006). The association was not significant for those older than 65 years.


CONCLUSIONS
Further studies should be conducted on possible mechanisms relating bone nociception to chronic NSLBP in individuals who are 65 years or younger.
Breuer
Brenda
B
Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, New York 10003, USA. bbreuer@chpnet.org
Pappagallo
Marco
M
Ongseng
Fukiat
F
Akhtar
Hena
H
Goldfarb
Richard
R
D000293:Adolescent; D000328:Adult; D001847:Bone Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002648:Child; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology*; D008297:Male; D018579:Patient Selection; D011859:Radiography; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D011795:Surveys and Questionnaires; D013669:Technetium Tc 99m Medronate / Q000493:pharmacokinetics
D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate