Skip to main content

Advertisement

Log in

Positive relationship between bone mineral density and low back pain in middle-aged women

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

There have been a large number of epidemiological studies demonstrating various primary factors that cause musculoskeletal disorders in middle-aged and older women. However, the relationship between low back pain and bone mineral density is not well documented, and no evidence for any direct relationship between the two has been found. To investigate the relationship, we conducted a cross-sectional study, on a population of 2,244 Japanese women aged 25–85 years who were participating in a regional health screening program. Information on lifestyle, reproductive characteristics and the presence of current low back pain was collected by self-administered questionnaires, and bone mineral density at the distal radius was measured. We found increasing bone mineral density to be significantly associated with low back pain in middle-aged women using a logistic regression analysis. Exercise and smoking were also significantly associated with low back pain. This association remained even after entering other lifestyle and reproductive factors into the final model. Accordingly, high bone mineral density would seem to be as important a public health problem as low bone mineral density and osteoporosis when considering the musculoskeletal symptoms and disabilities that appear in middle-aged women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Awbrey BJ, Jacobson PC, Grubb SA, et al (1984) Bone density in women: a modified procedure for measurement of distal radial density. J Orthop Res 2:314–321

    CAS  PubMed  Google Scholar 

  2. Badley EM, Rasooly I, Webster GK (1994) Relative importance of musculoskeletal disorders as a cause of chronic health problems, disability, and health care utilization: findings from the 1990 Ontario Health Survey. J Rheumatol 21:505–514

    CAS  PubMed  Google Scholar 

  3. Belmonte-Serrano MA, Bloch DA, Lane NE, et al (1993) The relationship between spinal and peripheral osteoarthritis and bone density measurements. J Rheumatol 20:1005–1013

    CAS  PubMed  Google Scholar 

  4. Bergenudd H, Nilsson B, Uden A, et al (1989) Bone mineral content, gender, body posture, and build in relation to back pain in middle age. Spine 14:577–579

    CAS  PubMed  Google Scholar 

  5. Cassidy JD, Carroll LJ, Cote P (1998) The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine 23:1860–1866

    Article  CAS  PubMed  Google Scholar 

  6. Cockerill W, Ismail AA, Cooper C, et al (2000) Does location of vertebral deformity within the spine influence back pain and disability? European Vertebral Osteoporosis Study (EVOS) Group. Ann Rheum Dis 59:368–371

    Article  CAS  PubMed  Google Scholar 

  7. Dequeker J (1997) Inverse relationship of interface between osteoporosis and osteoarthritis. J Rheumatol 24:795–798

    CAS  PubMed  Google Scholar 

  8. Deyo RA, Tsui-Wu YJ (1987) Descriptive epidemiology of low-back pain and its related medical care in the United States. Spine 12:264–268

    CAS  PubMed  Google Scholar 

  9. Ettinger B, Black DM, Nevitt MC, et al (1992) Contribution of vertebral deformities to chronic back pain and disability. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 7:449–456

    CAS  PubMed  Google Scholar 

  10. Fujiwara A, Tamai K, Yamato M, et al (1999) The relationship between facet joint osteoarthritis and disc degeneration of the lumbar spine: an MRI study. Eur Spine J 8:396–401

    Article  CAS  PubMed  Google Scholar 

  11. Genant HK, Wu CY, van Kuijk C, et al (1995) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8:1137–1148

    Google Scholar 

  12. Goker B, Sumner DR, Hurwitz DE, et al (2000) Bone mineral density varies as a function of the rate of joint space narrowing in the hip. J Rheumatol 27:735–738

    CAS  PubMed  Google Scholar 

  13. Hillman M, Wright A, Rajaratnam G, et al (1996) Prevalence of low back pain in the community: implications for service provision in Bradford, UK. J Epidemiol Community Health 50:347–352

    CAS  PubMed  Google Scholar 

  14. Huang C, Ross P, Wasnich R (1996) Vertebral fractures and other predictors of back pain among older women. J Bone Miner Res 11:1026–1032

    CAS  PubMed  Google Scholar 

  15. Ismail AA, Cooper C, Felsenberg D, et al (1999) Number and type of vertebral deformities: epidemiological characteristics and relation to back pain and height loss. European Vertebral Osteoporosis Study Group. Osteoporosis Int 9:206–213

    Article  CAS  Google Scholar 

  16. Iwahashi M, Matsuzaki H, Tokuhashi Y, et al (2002) Mechanism of intervertebral disc degeneration caused by nicotine in rabbits to explicate intervertebral disc disorders caused by smoking. Spine 27:1396–1401

    Article  PubMed  Google Scholar 

  17. Lau EM, Egger P, Coggon D, et al (1995) Low back pain in Hong Kong: prevalence and characteristics compared with Britain. J Epidemiol Community Health 49:492–494

    CAS  PubMed  Google Scholar 

  18. Lawrence JS (1969) Disc degeneration. Its frequency and relationship to symptoms. Ann Rheum Dis 28:121–138

    CAS  PubMed  Google Scholar 

  19. Luoma K, Riihimaki H, Luukkonen R, et al (2000) Low back pain in relation to lumbar disc degeneration. Spine 25:487–492

    Article  CAS  PubMed  Google Scholar 

  20. Matthis C, Weber U, O’Neill TW, et al (1998) Health impact associated with vertebral deformities: results from the European Vertebral Osteoporosis Study (EVOS). Osteoporosis Int 8:364–372

    Article  CAS  Google Scholar 

  21. Miyakoshi N, Itoi E, Murai H, et al (2003) Inverse relation between osteoporosis and spondylosis in postmenopausal women as evaluated by bone mineral density and semiquantitative scoring of spinal degeneration. Spine 28:492–495

    Article  PubMed  Google Scholar 

  22. Nanjo Y, Morio Y, Nagashima H, et al (2003) Correlation between bone mineral density and intervertebral disk degeneration in pre- and postmenopausal women. J Bone Miner Metab 21:22–27

    Article  PubMed  Google Scholar 

  23. Nathan H (1962) Osteophytes of the vertebral column. J Bone Joint Surg Am 44:243–268

    Google Scholar 

  24. Nicholson PHF, Haddaway MJ, Davie MWJ, et al (1993) Vertebral deformity, bone mineral density, back pain and height loss in unscreened women over 50 years. Osteoporosis Int 3:300–307

    CAS  Google Scholar 

  25. Nourbakhsh MR, Moussavi SJ, Salavati M (2001) Effects of lifestyle and work-related physical activity on the degree of lumbar lordosis and chronic low back pain in a Middle East population. J Spinal Disord 14:283–292

    Article  CAS  PubMed  Google Scholar 

  26. O’Neill TW, Felsenberg D, Varlow J, et al (1996) The prevalence of vertebral deformity in European men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res 11:1010–1018

    PubMed  Google Scholar 

  27. Palmer KT, Syddall H, Cooper C, et al (2003) Smoking and musculoskeletal disorders: findings from a British national survey. Ann Rheum Dis 62:33–36

    Article  CAS  PubMed  Google Scholar 

  28. Papageorgiou AC, Croft PR, Ferry S, et al (1995) Estimating the prevalence of low back pain in the general population. Evidence from the South Manchester Back Pain Survey. Spine 20:1889–1894

    CAS  PubMed  Google Scholar 

  29. Peel NF, Barrington NA, Blumsohn A, et al (1995) Bone mineral density and bone turnover in spinal osteoarthrosis. Ann Rheum Dis 54:867–871

    CAS  PubMed  Google Scholar 

  30. Radin EL, Rose RM (1986) Role of subchondral bone in the initiation and progression of cartilage damage. Clin Orthop 213:34–40

    PubMed  Google Scholar 

  31. Ross P, Huang C, Davis J, et al (1995) Predicting vertebral deformity using bone densitometry at various skeletal sites and calcaneus ultrasound. Bone 16:325–332

    Article  CAS  PubMed  Google Scholar 

  32. Symmons DP, van Hemert AM, Vandenbroucke JP, et al (1991) A longitudinal study of back pain and radiological changes in the lumbar spines of middle aged women. II. Radiographic findings. Ann Rheum Dis 50:162–166

    CAS  PubMed  Google Scholar 

  33. Verstraeten A, Van Ermen H, Haghebaert G, et al (1991) Osteoarthrosis retards the development of osteoporosis. Observation of the coexistence of osteoarthrosis and osteoporosis. J Clin Orthop 264:169–177

    Google Scholar 

  34. Vogt MT, Hanscom B, Lauerman WC, et al (2002) Influence of smoking on the health status of spinal patients: the National Spine Network database. Spine 27:313–319

    Article  PubMed  Google Scholar 

  35. von der Recke P, Hansen MA, Overgaard K, et al (1996) The impact of degenerative conditions in the spine on bone mineral density and fracture risk prediction. Osteoporosis Int 6:43–49

    Google Scholar 

  36. Walker BF (2000) The influence of low back pain: a systematic review of the literature from 1966 to 1998. J Spinal Disord 13:205–217

    Article  CAS  PubMed  Google Scholar 

  37. Warming L, Hassager C, Christiansen C (2002) Changes in bone mineral density with age in men and women: a longitudinal study. Osteoporosis Int 13:105–112

    Article  CAS  Google Scholar 

  38. Zetterberg C, Mannius S, Mellstrom D, et al (1990) Osteoporosis and back pain in the elderly. A controlled epidemiologic and radiographic study. Spine 15:783–786

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported by a Health Science Research Grant for Research Projects on Aging and Health from the Ministry of Health and Welfare of Japan. The English used in this manuscript was revised by Miss K. Miller (Royal English Language Centre, Fukuoka, Japan).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shin-ichiro Takasugi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Manabe, T., Takasugi, Si. & Iwamoto, Y. Positive relationship between bone mineral density and low back pain in middle-aged women. Eur Spine J 12, 596–601 (2003). https://doi.org/10.1007/s00586-003-0585-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-003-0585-0

Keywords

Navigation