Non-specific backache.
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Though uncommon, osteoporosis can occur in pregnancy or shortly after delivery. The most common feature is back pain, often severely disabling. Suspect osteoporosis if pain of sudden onset in the upper lumbar or thoracic spine is not relieved by simple analgesia, or if there is a noticeable loss of height. X-rays reveal low bone density and fractures of the vertebrae. 70% of cases occur in first pregnancies. Recurrence is unusual. Most cases resolve spontaneously; a minority cause disability lasting months or years. If osteoporosis is diagnosed, breast feeding should be discouraged because of its effect on bone mineral density. Anyone who has had osteoporosis of pregnancy is at risk of postmenopausal osteoporosis and should take medical advice.
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Chronic back pain leading to invalidity has become a social medical problem of enormous proportions. After several months off work, efforts at rehabilitation often fail because secondary effects prevent the return to normal daily activities. For this reason, early detection and prevention of chronicity is of considerable importance. The background to the development of chronicity is complex. In addition to the wide range of somatic and psychosocial factors, the roles played by the physicians and social insurances are also examined.