Dr. Lasich, thank you so much for covering this topic! We get many questions on our Q&A (Ask a Question board) about whether or not osteoporosis alone can cause pain. Since all of the osteoporosis organizations have told us this is a silent disease, and we don't experience pain until we fracture, this explanation helps to counter that advice, which has always been a problem for me to understand, and apparently I'm not alone in this understanding of possible pain with bone loss.

I've had many spinal frax's and also pain from inflammation/nerve irritation, due to other problems with my spine, and I have asked many times if bone loss alone - without a fracture - could cause pain. The answer I always received was NO; it doesn't cause pain until there's a fracture, and I have always disagreed with this logic.

Having this great information available to our members will fully explain how you could have pain without a fracture; so thanks so much for explaining this oft-discussed topic.

It's also good to hear again, that Calcitonin spray/injection can be used successfully for pain. I've tried to get this type of treatment, but not all doctors understand it's ability to treat pain, especially after a fracture; some doctor's only use it to treat osteoporosis and osteopenia. I'm so glad you confirmed this for all of us as well!  One problem I've had is that my insurance will not cover two osteoporosis meds at once.  When I took Forteo, I wanted to include Calcitonin as well for pain but it wasn't covered, so I hope that has changed.

I hadn't heard about Actonel's ability to help with pain, so that's good to know as well.

Thanks again...

Pam