What is the difference between back pain due to osteoporosis and lumbar disc herniation?

Osteoporosis is a clinical syndrome caused by a variety of reasons, such as a generalized decrease in the number of bones, an increase in the trabecular space, a decrease in the matrix and weight of the bone, and a decrease in the mechanical strength of the bone, leading to non-traumatic fractures, or fractures in certain parts of the body occurring with a slight external force. The etiology and pathogenesis of osteoporosis are not yet fully understood. At present, the more recognized causes of the disease include the following aspects: (1) endocrine disorders: as we all know, this disease is more common in the elderly, especially after menopause is particularly common in female patients. This suggests that sex hormones have a direct relationship to bone metabolism. When the hyperadrenocorticism can cause osteoporosis, not only is the main feature of Cushing’s syndrome, but also in the clinical treatment of long-term use of adrenocorticotropic hormone to the patient can also cause this consequence. This suggests that adrenocorticotropic hormones accelerate the process of osteoporosis. Sex hormones inhibit anterior pituitary hormones, which indirectly inhibit adrenocorticotropic hormones. Therefore, the elderly sex hormone secretion is reduced, especially after menopause, women are more prone to osteoporosis. (2) Dysregulation of calcium metabolism: There is no doubt that calcium deficiency is one of the causes of osteoporosis in adults. Normal people’s daily intake of calcium is about 10mg/kg body weight, of which a small amount is utilized by the body, and most of it is excreted with urine and stool to maintain the balance of calcium metabolism. If the amount of calcium intake is reduced, or intestinal absorption dysfunction, or increased excretion from urine and stool, it is easy to cause osteoporosis caused by calcium deficiency. At this time, if coupled with the influence of endocrine disorders, it is more likely to cause osteoporosis. (3) Waste factors: under normal circumstances, due to muscle diastole and contraction and a variety of stress and pressure and stimulate the skeletal tissue to maintain a normal balance of calcium metabolism. But when the limbs or the whole body once lost physiological activities and physical labor or exercise, it is easy to cause a series of changes in the bone tissue and trigger decalcification and increased urinary calcium excretion, resulting in osteoporosis. Long-term bedridden people show generalized osteoporosis, while limb plaster splint fixation or neurological disuse, it shows local osteoporosis. Osteoporosis is most common in the elderly, especially in women over 60 years old. Patients often complain of general fatigue, preferring to lie down or sit up rather than move; generalized pain, especially in the lumbar region, which can be dispersed from the lumbar region to the buttocks and lower limbs, or from the back to the ribs and abdomen. The patients themselves feel that their height is gradually becoming shorter, in addition to the degeneration of the intervertebral disc, and the osteoporosis of the vertebral body is easy to cause compression fracture. The same reason can make the hunchback deformity gradually aggravate. X-ray manifestation: osteoporosis of the spine, reduction of bone trabeculae, depression in the middle of the vertebral body, showing a fishtail shape. The degree of pain caused by osteoporosis is far less serious than that of lumbar disc herniation, and the X-ray manifestations are very different. The symptoms of low back pain can be alleviated after the application of sex hormones, high protein, and high calcium treatments.