Hayashi Yasufumi
Tokyo Metropolitan Rehabilitation Hospital, Department of Orthopaedics.
Clin Calcium. 2007 Apr;17(4):606-12.
Approximately 85 % of the patients with osteoporosis are suffered from bone pain. And almost 100 % of the patients eagerly ask the physician to relieve their pain. But many physicians concerning treatment of osteoporosis had been interested in increase of bone mineral density, decrease of fracture rate and improvement of bone quality, instead of relief of the pain. A reason of indifference of medical doctor for pain relief would be based on uncertain pathogenesis of bone pain, such as many spinal fractures occurred without pain in the huge study of clinical efficacy of a bisphosphonate. Recently, a detailed study focused on spinal pain revealed that 90% of spinal fracture were accompanied the pain. On the other hand, many bisphosphonates in addition to calcitonin were clarified to show analgesic effect. So many medical doctors have been interested in relief of osteoporotic pain. The purpose of treatment of osteoporosis in 21st century would again become relief of the pain, based on the reduction of fracture rate.
约85%的骨质疏松症患者患有骨痛。几乎100%的患者急切地要求医生缓解他们的疼痛。但是,许多关注骨质疏松症治疗的医生一直对增加骨矿物质密度、降低骨折率和改善骨质感兴趣,而非缓解疼痛。医生对缓解疼痛漠不关心的一个原因可能是骨痛的发病机制尚不明确,比如在一项关于双膦酸盐临床疗效的大型研究中,许多脊柱骨折并无疼痛症状。最近,一项针对脊柱疼痛的详细研究表明,90%的脊柱骨折伴有疼痛。另一方面,除降钙素外,许多双膦酸盐也被证实具有镇痛作用。因此,许多医生开始关注骨质疏松症疼痛的缓解。基于骨折率的降低,21世纪骨质疏松症治疗的目的将再次转变为缓解疼痛。