ALLAN METZGER, MD: Patients confuse it because they have a sense that osteoporosis gives them pain. In general, patients confuse it and unfortunately once in a while physicians are not aware enough about osteoporosis to put that in a differential diagnosis of how they approach the patient.
NIKI MOHAN: Now what if someone comes in the office and they say, "My back's hurting. I've had this back pain here." How does that feel different from osteoporotic pain?
ALLAN METZGER, MD: It generally does. If someone comes in with a back pain, for example, a woman who's 40, who's still having her periods, 99 percent of the time it will not be osteoporosis or a fracture because theoretically they still have estrogen and theoretically they don't have osteoporosis unless they haveother risk factors.
Women who are, say in their 70's, who have not been on estrogen, who present with sudden terrible back pain, I'm always concerned about a disk or a fracture.
NIKI MOHAN: What are those risk factors? Let's run through them.
ALLAN METZGER, MD: The important risk factors are related to genetics. We know there is a high risk in families. If a mother has osteoporosis and/or a fracture, there is a higher risk for the daughter or even the son. Other risk factors are clearly related to menopause -- early menopause or late onset of periods --so estrogen deficiency is a risk factor.