Upper Back Pain Case Study
Mary, a 72 year old woman, comes to your clinic for a complete physical exam. Her
only complaint is 6/10 “upper back pain,” which started about 3 weeks ago as she was getting
out of bed. She describes the pain as sharp and stabbing.
Mary hasn’t been to a doctor for 11 years, she says, “I don’t like those doctors.”
She has smoked a pack a day for 17 years. She says, “I know I should quit smoking and start
exercising, but I’m too tired. And anyway, I’m not fat.” She went through menopause at 47, and
has never taken hormone replacement therapy.
Patient is A+OX4. Physical examination is normal, except moderate tenderness to
palpation over the spinous process at T7. No mass, skin changes, or erythema are noted.
Neurologic assessment is normal.
An X-Ray indicates a collapsed thoracic vertebra at T7 and bone density changes in the
spine. What could this indicate?