Pain in Osteoporosis: From Pathophysiology to a Therapeutic Approach

Dear Colleagues,

Osteoporosis (OP) is the most common metabolic bone disease. It has become a major public health problem in many countries due to the increase in life expectancy. It has been estimated that, by the year 2025, more than 30 million women and men aged > 65 years will be affected by osteoporosis in the EU. Fractures occur in patients with OP after low energy traumas, and, particularly, hip fractures may be a significant cause of mortality. Pain, functional loss, social isolation, and emotional disturbances may negatively affect patients’ general well-being and quality of life. Vertebral fractures (VFs) represent a typical finding in patients with osteoporosis, with up to 12% of postmenopausal women having at least one vertebral deformity, most of which are osteoporotic VFs. These women show a higher risk of further vertebral and other osteoporotic fractures, impairing health status. Osteoporotic fractures carry a high social burden, and sites typically include the femoral neck, vertebrae, and distal forearm. Chronic pain, disability, and impaired quality of life secondary to fractures are commonly observed in patients with osteoporosis, leading to increased financial costs. Although osteoporosis is known as a silent disease affecting aging populations, its primary symptom remains pain. Acute pain is reported by patients with osteoporosis-related fractures, but chronic pain, mainly back pain, is also a characteristic of severe osteoporosis. Pain is associated not only with fractures but also with bodily changes in patients with osteoporosis that may include sensory, affective, and cognitive aspects. Chronic pain leads to progressive loss of independence and the need for long-term care, especially in the elderly. Pain prevention is linked to the appropriate treatment of osteoporosis, and pain management in patients with osteoporosis requires a multidimensional approach to preserve and improve quality of life. The present Special Issue aims to the main causes of pain in patients with osteoporosis and suggest possible strategies for its management, treatment, and prevention.

Dr. Daniela Merlotti
Guest Editor

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• Osteoporosis
• Musculoskeletal pain
• Vertebral fractures
• Sarcopenia
• Bisphosphonate treatment
• Pain management
• Quality of life