Exploring the Association between Pain and Fracture Characteristics in Women with Osteoporotic Vertebral Fractures

The purpose of this study was to estimate the association between pain and the number, severity, and location of fractures in women with osteoporotic vertebral fractures. We used an 11-point numeric pain rating scale to assess pain during movement in the preceding week and lateral spinal radiographs to confirm number, location, and severity of vertebral fractures. In model 1, we assessed the association between pain during movement and the number, severity, and location of fractures. We adjusted model 2 for pain medication use and age. The mean age of participants was 76.4 (SD 6.9) years. We found no statistically significant associations between pain and fracture number (estimated β = 0.23, 95% CI: -0.27, 0.68), fracture severity (estimated β = -0.46, 95% CI: -1.38, 0.49), or fracture location at T4-T8 (estimated β = 0.06, 95% CI: -1.26, 1.34), T9-L1 (estimated β = 0.35, 95% CI: -1.17, 1.74), or L2-L4 (estimated β = 0.40, 95% CI: -1.01, 1.75). Age and pain medication use were not significantly associated with pain. Model 1 accounted for 4.7% and model 2 for 7.2% of the variance in self-reported pain. The number, location, and severity of fractures do not appear to be the primary explanation for pain in women with vertebral fractures. Clinicians must consider other factors contributing to pain.