Back Problems and Atherosclerosis

STUDY DESIGN: A cross-sectional and prospective study of osteoporotic fractures. OBJECTIVES: To investigate the correlation between lower extremity arterial disease or history of cardiovascular disease and back pain, back function, osteoporosis, and vertebral fractures. BACKGROUND: It has been postulated that atherosclerosis may compromise blood flow to bone and soft tissues in the back, causing pain and disability. Recent studies have presented conflicting results. METHODS: At baseline, information on back pain and function, general functional status, cardiovascular history, and general lifestyle variables was obtained from 1492 elderly white women (mean age, 71 years) enrolled in the Study of Osteoporotic Fractures. Lateral radiographs of the lumbar and thoracic spine were obtained, and lower extremity arterial disease was assessed. Follow-up information was obtained an average of 3.7 years later. RESULTS: At baseline, 82 women had arterial disease, 443 had a history of cardiovascular disease, and 277 had vertebral fractures; 58 women had one or more additional vertebral fractures during the follow-up period. After adjustment for age, women with cardiovascular disease were more likely to have back pain and disability as a result of the back pain than women free of cardiovascular disease; at the follow-up examination, the back-related disability was more than twice as likely to have worsened in the cardiovascular disease group. No correlation was found between arterial disease and back problems. Neither the prevalence of vertebral fractures at baseline, nor the incidence of vertebral fractures was associated with the presence of arterial disease or cardiovascular disease. CONCLUSIONS: Results indicated that back problems in elderly women are associated with self-reported cardiovascular disease, but not with objectively assessed lower extremity arterial disease.