27 Osteoporotic Pain

Pain derived from musculoskeletal disorders play a major role in the health profile of the general population (Badley et al., 1994). Generally, osteoporosis patients experience several kinds of pain, including LBP: pain derived from external injury such as from fractures of the compressed vertebrae or femoral neck, and pain from internal consequences of the osteoporotic state without injury, which has been reported to account for pain in 89% of menopausal osteoporosis patients (Scharla et al., 2006). The exact mechanism for that pain still remains unknown, but some studies have tried to clarify that. In a previous study in which SPECT RI, bone scintigraphy, and X-rays were used, pain from injury was reported to be caused by collapsed vertebral bodies and degenerated intervertebral disc and facet joints (Ryan et al., 1992), which proved one of the evidence of injury-derived pain. The injuryderived pain in osteoporosis patients tends to turn into acute pain, whereas the non-injuryderived pain tends to take a chronic course, among which the latter must be sought for its pathogenesis. Here, we define pain derived from osteoporosis without any fractures or injuries as “osteoporotic pain.” In this chapter, we review osteoporotic pain by showing the association between its possible mechanism and treatment. Regarding the detailed pharmacological character and use of each anti-osteoporosis agent, please refer to the other appropriate chapters.