Osteoporosis Pain

Assessing Pain and Quality-of-Life

In addition to back pain, other clinical symptoms of vertebral fracture are loss of spine mobility, loss of height, and diminished function. These symptoms are associated with difficulty in rising, dressing, and climbing stairs. Deterioration in quality-of-life is more pronounced in patients with multiple fractures. When the diagnosis is suspected, baseline radiographs and densitometric measurement should be performed. In osteoporosis, psychosocial and quality-of-life assessment is very important, as depression is a common comorbidity. Common complaints reported include sleep problems, reduced appetite, and feeling blue, hopeless, and isolated.

Direct questioning is needed to evaluate the effects of osteoporosis on functional status.²⁵ The Osteoporosis Quality-of-life Questionnaire (OQLQ) covers 30 items described across 5 domains (symptoms, physical function, ADLs, emotional function, and leisure). The validated questionnaire compares favorably to the Sickness Impact Profile, the short form of the Medical Outcomes Survey, and the Brief Pain Inventory at detecting improvement or deterioration in quality-of-life.²⁶ A shortened version of the OQLQ is available.²⁷