Making a Back Pain Diagnosis: Dual Energy X-Ray Absorptiometry (DEXA or DXA)

Dual Energy X-Ray Absorptiometry (DEXA or DXA) is an imaging tests to determine the mineral density of patient's bones. This bone density test is used to diagnose osteoporosis, one of the causes of back pain. the presence of mineral density loss of bones is not a direct cause of back pain, but it indicates osteoporosis, the cause of most vertebral fractures that are not injury related, which can be painful. DXA uses non-harmful levels of radiation to photograph the bones of the spine and determine their density, or thickness. DXA can also be used on the other bones of the body.

Though osteoporosis is associated with the aging process, this disease or condition can be slowed through a combination of exercise, diet changes, and medications. These medical and lifestyle changes may be able to significantly improve the density of weight bearing bones such as the pelvis and lumbar vertebrae, and be able to prevent future fractures.

DEXA is one of the most common diagnostic tests used in back pain medicine. Other tests that measure bone density include:
  • pQTC - Peripheral quantitative computer tomography
  • QUS - Quantitative ultrasound
  • pDXA - Peripheral dual energy X-ray absorptiometry
  • RA - Radiographic absorptiometry
  • QTC Quantitative computer tomography
  • SXA - Single X-Ray absorptiometry

Treatments for Osteoporosis: Osteoporosis occurs in both men and women, but it is a condition more common to middle aged to elderly women who have stopped post-menopause. Treatment options include:
  • Exercise: Exercise that include weight bearing exercises, resistance exercises, and aerobics have been shown to increase bone density. Research has shown that the body needs to be challenged against a gravity environment, as evidenced in the observations of bone density loss in astronauts who have spent short to moderate times in space. When we push against gravity (i.e. walking, running) or against a resistant force (i.e. free weights, squats) the force exerted on the bones and muscles stimulate muscle growth and bone growth. Common exercises thought to be good for stimulating bone growth include weight training sessions, leg press, lateral pulldown, and the military press.
  • Nutrition: Certain vitamins in minerals in a natural and healthy diet can help people at risk for osteoporosis to maintain or increase bone density. Calcium and Vitamin D are considered two essential vitamins and minerals for synthesis of new bone formation. Some natural sources of calcium include animal proteins, especially dairy. Vitamin D is one of the vitamins need in the chain reaction of chemical reactions that results in new bone growth. Some common sources of Vitamin D include natural sunlight. Exposure to ultra-violet light from tanning beds also promoted absorption of Vitamin D through the skin. It is never too early to promote a healthy style to protect against osteoporosis. So if your daily lifestyle typically involves minute amounts of sun exposure between trips to and from the home, car, and office only, you should make modifications. Commit to spending time out in the sun, at least in the summer months when it is available for free to be enjoyed.
  • Bone anabolic agents:
  • Antiresorptive agents:
  • Other agents: Strontium ranelate and RANKL inhibitors have proven helpful at slowing down the process of bone density loss.