Risedronate decreases bone resorption and improves low back pain in postmenopausal osteoporosis patients without vertebral fractures.
Elderly postmenopausal women who have osteoporosis sometimes experience low back pain, however, the relationship between low back pain and osteoporosis in the absence of vertebral fractures remains unclear. We examined the relationship between bone mineral density (BMD), bone resorption and low back pain in elderly female patients who did not have osteoporotic vertebral fractures. The average BMD was 0.675 g/cm(2) when assessed by dual-energy X-ray absorptiometry (DEXA). Patients were excluded from the study if they had vertebral fractures revealed by radiography, CT scans or MRI. Bisphosphonate (risedronate) was administered for 4 months. The visual analogue scale (VAS) pain score, Roland Morris Disability Questionnaire (RDQ), Short Form-36 (SF-36) questionnaire, BMD and N-terminal telopeptide of type I collagen (NTx; a marker for bone resorption) were examined before and after treatment. DEXA did not increase significantly, but serum and urinary NTx were decreased (-51.4% and -62.0%, respectively) after 4 months of risedronate treatment (p<0.01). The assessment was repeated using the VAS score, RDQ and SF-36, which revealed an improvement after risedronate treatment (p<0.01). A decrease in serum and urinary NTx was associated with improvement of low back pain, suggesting that despite the absence of vertebral fractures, bone resorption due to osteoporosis may cause low back pain.
Ohtori
Seiji
S
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba 260-8670, Japan. sohtori@faculty.chiba-u.jp
Akazawa
Tsutomu
T
Murata
Yasuaki
Y
Kinoshita
Tomoaki
T
Yamashita
Masaomi
M
Nakagawa
Koichi
K
Inoue
Gen
G
Nakamura
Junichi
J
Orita
Sumihisa
S
Ochiai
Nobuyasu
N
Kishida
Shunji
S
Takaso
Masashi
M
Eguchi
Yawara
Y
Yamauchi
Kazuyo
K
Suzuki
Munetaka
M
Aoki
Yasuchika
Y
Takahashi
Kazuhisa
K
D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis / Q000097:blood / Q000652:urine; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000008:administration & dosage; D001862:Bone Resorption / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control; D024042:Collagen Type I / Q000032:analysis / Q000097:blood / Q000652:urine; D012968:Etidronic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D010147:Pain Measurement / Q000187:drug effects; D011446:Prospective Studies; D000068296:Risedronic Acid; D016103:Spinal Fractures / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D015415:Biomarkers; D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D000068296:Risedronic Acid; D012968:Etidronic Acid