Risedronate decreases bone resorption and improves low back pain in postmenopausal osteoporosis patients without vertebral fractures.

Abstract

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.

• Authors: Seiji Ohtori, Tsutomu Akazawa, Yasuaki Murata, Tomoaki Kinoshita, Masaomi Yamashita, Koichi Nakagawa, Gen Inoue, Junichi Nakamura, Sumihisa Orita, Nobuyasu Ochiai, Shunji Kishida, Masashi Takaso, Yawara Eguchi, Kazuyo Yamauchi, Munetaka Suzuki, Yasuchika Aoki, Kazuhisa Takahashi
• Journal: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia (J Clin Neurosci) Vol. 17 Issue 2 Pg. 209-13 (Feb 2010) ISSN: 1532-2653 [Electronic] Scotland
• PMID: 20044258 (Publication Type: Clinical Trial, Journal Article)
• Copyright: Copyright 2009 Elsevier Ltd. All rights reserved.

Chemical References

• Biomarkers
• Bone Density Conservation Agents
• Collagen Type I
• Risedronic Acid
• Etidronic Acid

Topics

• Absorptiometry, Photon
• Aged
• Aged, 80 and over
• Biomarkers (analysis, blood, urine)
• Bone Density (drug effects, physiology)
• Bone Density Conservation Agents (administration & dosage)
• Bone Resorption (drug therapy, physiopathology, prevention & control)
• Collagen Type I (analysis, blood, urine)
• Etidronic Acid (administration & dosage, analogs & derivatives)
• Female
• Humans
• Low Back Pain (drug therapy, etiology, physiopathology)
• Middle Aged
• Osteoporosis, Postmenopausal (complications, drug therapy, physiopathology)
• Pain Measurement (drug effects)
• Prospective Studies
• Risedronic Acid
• Spinal Fractures (drug therapy, etiology, prevention & control)
• Surveys and Questionnaires
• Treatment Outcome