Persistent back pain after osteoporotic fractures

Abstract

Two cases are presented of low back pain following osteoporotic fractures. In both cases, the pain was located below and not at the level of the fracture; however, evidence of this location varied. In one case, skin changes indicated the area of pain, while in the other, a pain drawing showed the distribution. The mechanism for this pain is discussed, and the hypothesis put forward that in these patients biomechanical changes cause stress-induced pain in the muscles below the collapsed vertebral body during forward bending. While the fractures were easily diagnosed, the origin of pain was misinterpreted until it was revealed by a rather commonplace pain drawing and clinical examination.

Key Words:

• back pain
• osteoporosis
• myofascial