Effect of Intravenous Zoledronic Acid on Pain and Functional Disability in Patients with Osteoporosis-Associated Chronic Low Back Pain: A Prospective Interventional Study

Background: Chronic low back pain is common in older adults and may coexist with osteoporosis and degenerative spinal changes. Zoledronic acid is an antiresorptive bisphosphonate used in osteoporosis; its association with changes in pain and function in this population warrants clinical evaluation. Aim: To evaluate changes in pain intensity and functional disability after intravenous zoledronic acid in patients with chronic low back pain associated with osteoporosis. Materials and Methods: This hospital-based interventional study included 41 patients aged over 50 years at the Department of Orthopaedics, between March 2023 and March 2025. Participants received a single 4-mg intravenous infusion of zoledronic acid diluted in 100 mL normal saline. Pain and disability were assessed at baseline, three months and six months using the Visual Analogue Scale (VAS) and Roland-Morris Disability Questionnaire (RMDQ), respectively. Results: The study included 21 male patients (51.2%) and 20 female patients (48.8%); mean age was approximately 63 years (range 51-79). The detailed results section reports mean VAS scores of 8.05 at baseline, 4.85 at three months and 2.95 at six months. Mean RMDQ scores were reported as 19.05, 12.07 and 6.95, respectively. The dissertation reports statistically significant improvement at three months (p < 0.01). Adverse effects were described as minimal, but event counts require verification from the original records. Conclusion: Pain and self-reported functional disability improved over six months following zoledronic acid administration in this single-arm cohort. Controlled studies are required to determine the magnitude of benefit attributable to treatment.