Does osteoporosis end my running career? (The Clinic).

I have been running competitively since elementary school. I am now 47 years old. Last year my doctor recommended a bone density scan because of lower back pain I had, especially after running. The result showed osteopenia (slightly reduced bone mass) of the lower spine. I continued to run my usual 35 miles per week, reducing my pace. A follow-up bone density scan was done this year and showed further bone loss, resulting in osteoporosis of the lower spine. Should I continue to run?

Pamela Hardwick

Minneapolis, MN

Osteoporosis and osteopenia are important health issues, particularly for postmenopausal women and for women who have menstrual irregularities, which is not uncommon among competitive and elite female runners. Typically, weight-bearing activities like running help to maintain bone density, or at least to slow the decrease in bone density. Therefore, in the absence of menstrual irregularity, running itself is not contraindicated for women who are osteopenic or osteoporotic. Further, slowing your pace most likely will not influence your bone density.

The issue of your back pain is another matter. It is frequently misunderstood that osteopenia and osteoporosis result in back pain. Only if there is an associated spinal fracture would osteoporosis be the indirect cause of back pain. However, there are numerous other reasons for back pain that are unrelated to osteopenia or osteoporosis.

You need a thorough medical assessment addressing the cause of your osteoporosis as well as the cause of your lower back pain. Until these two issues are clarified, I would not discontinue running. Once all of the medical information is obtained you can determine if running will make it worse. You should see a sports medicine specialist to address the issues associated with both the cause of osteoporosis and the cause of your back pain. Osteoporosis, in itself, should not limit your running.

Stuart M Weinstein, MD.

Seattle, WA