Helen is a petite, 74 year-old woman who smokes half a pack of cigarettes a day, drinks socially and isn’t physically active most of the time. Her back pain developed suddenly, starting in upper back and then extending down her spine. Sometimes it spreads around the sides of her chest. She can’t recall any unusual event that might have triggered this pain, although she does remember slipping as she stepped off a curb.

“I didn’t even fall. I just remember pitching forward suddenly, then righting myself. I didn’t fall down. The pain is constant now and gets worse whenever I move my back, no matter how slightly. It gets even worse when I try to bend forward or reach for something and only gets a little better if I lie on my reclining chair. It’s a bit less now than when it first started, so I’m trying to be hopeful.”

Back pain in someone like Helen can be a sign of a compression fracture to one of the bones in the back (the vertebrae). Such small fractures can be a source of pain and disability for older women. They’re also the most common type of fracture due to osteoporosis.

Osteoporosis is a condition where thinning of the internal structure of the bones and makes them weak. It usually affects postmenopausal women. Men are less often affected because they have more bone mass to begin with and do not undergo the same hormonal changes. Smoking, inactivity, and moderate use of alcohol are known to increase the risk of osteoporosis. Osteoporosis itself is not painful but because the structure of the bone is now so fragile even a small movement can trigger a compression fracture, for example, slipping and righting oneself without actually falling. In more severe cases of osteoporosis, even coughing or sneezing can cause the bone to collapse.

People at risk for osteoporosis who develop sudden, unexplained back pain, should consult their family physicians. The doctor may suggest diagnostic testing to measure the density of the bone and detect a fracture then offer advice about treatment based on the findings. Read more about back pain due to osteoporosis.