A 31-year-old woman experienced severe back pain and broken bones in her spine just weeks after giving birth. Doctors initially missed what was actually causing her problem: a rare condition called pregnancy and lactation-associated osteoporosis, where bones become dangerously weak during pregnancy and breastfeeding. Her case highlights how this condition is often overlooked and misdiagnosed. The story also shows that common treatments like calcium supplements and bone-strengthening medications didn’t work as well as expected, especially for people with lower body weight. This case report reminds doctors to watch for this rare but serious condition and consider a patient’s weight when planning treatment.

The Quick Take

  • What they studied: A single case of a young woman who developed severe bone weakness and broken vertebrae (spine bones) during pregnancy and breastfeeding, and how doctors treated her condition.
  • Who participated: One 31-year-old Chinese woman with a lower-than-average body weight who developed back pain two weeks after delivering her first baby.
  • Key finding: The patient had a rare condition where pregnancy and breastfeeding caused her bones to become extremely weak and break. Standard treatments (calcium, vitamin D, and bone-strengthening drugs) helped with pain but didn’t significantly rebuild her bone strength over 19 months of follow-up.
  • What it means for you: If you experience severe back pain during late pregnancy or while breastfeeding, especially if you have a lower body weight, ask your doctor to check for this rare condition. Early diagnosis and stopping breastfeeding may help, though recovery can be slow. This is not common, but doctors need to recognize it when it happens.

The Research Details

This is a case report, which means doctors documented the medical history, diagnosis, and treatment of one specific patient. The woman came to the hospital with severe lower back pain that started two weeks after giving birth. Doctors initially thought physical therapy would help, but it made her pain worse. They then performed imaging tests (MRI) that showed multiple broken bones in her spine, and bone density tests confirmed she had severe osteoporosis—a condition where bones become fragile and break easily. Blood tests showed she was low in vitamin D but had normal calcium levels. After seeing a spine specialist, she was finally diagnosed with pregnancy and lactation-associated osteoporosis (PLO). The doctors then tracked her progress over 19 months while she received various treatments.

Case reports are important because they describe unusual or rare conditions that doctors might not see often. By documenting this patient’s experience in detail, other doctors can learn to recognize similar cases earlier. This is especially valuable for PLO because it’s rare and often missed, leading to delayed treatment and unnecessary suffering. The detailed description helps raise awareness among healthcare providers.

This is a single case report, so it describes only one person’s experience. While it provides valuable information about how this rare condition can present and be treated, we cannot draw broad conclusions that apply to everyone. The findings are based on one patient’s response to treatment, so results may differ for others. However, the detailed medical documentation and follow-up over 19 months make this a well-documented case that can guide future research and clinical practice.

What the Results Show

The patient developed multiple fractures in her spine (vertebral fractures) within two weeks of giving birth while breastfeeding. Initial treatments with calcium and vitamin D supplements alone did not relieve her severe back pain. After stopping breastfeeding and starting bone-strengthening medication (bisphosphonates), along with wearing a supportive back brace and continuing calcium and vitamin D, her pain gradually improved over several months. However, bone density tests at 19 months showed that her bones did not significantly rebuild their strength, even with medication. This suggests that the standard treatments for osteoporosis may not work as well for people with lower body weight who develop this pregnancy-related bone weakness.

The patient’s blood tests revealed vitamin D deficiency, which is a known risk factor for weak bones. Her lower-than-average body weight was identified as an important risk factor for developing this condition. The case demonstrates that physical therapy, which is normally helpful for back pain, actually made her symptoms worse initially because her bones were too fragile. Stopping breastfeeding appeared to help stabilize her condition, suggesting that the demands of milk production may contribute to bone loss during lactation.

Pregnancy and lactation-associated osteoporosis is recognized as a rare condition in medical literature, but this case report highlights that it remains underdiagnosed in clinical practice. Previous research has identified low body weight and vitamin D deficiency as risk factors, which this case confirms. However, the finding that bone-strengthening medications showed limited effectiveness in rebuilding bone density for this patient with low body weight suggests that current treatment approaches may need adjustment for this specific population. More research is needed to understand why standard treatments don’t work as well for some patients.

This report describes only one patient, so we cannot know if her experience applies to other people with this condition. Different patients may respond differently to the same treatments. The follow-up period of 19 months, while reasonably long, may not be enough time to see full bone recovery. We don’t know what would have happened if the patient had received different treatments or if she had been diagnosed earlier. Additionally, this case involves a Chinese woman, so results may not apply equally to people of other ethnic backgrounds. The case report cannot prove cause-and-effect relationships—it only describes what happened in this one situation.

The Bottom Line

If you experience severe back pain during late pregnancy or while breastfeeding, especially if you have a lower body weight, ask your doctor to evaluate you for pregnancy and lactation-associated osteoporosis. This may include bone density testing and blood work to check vitamin D levels. If diagnosed, stopping breastfeeding, taking calcium and vitamin D supplements, wearing supportive bracing, and considering bone-strengthening medications may help manage pain and prevent further fractures. However, recovery can be slow, and bone rebuilding may take considerable time. These recommendations are based on limited evidence from this single case, so discuss your individual situation with your healthcare provider. (Confidence level: Low to Moderate—based on one case report)

Pregnant women and new mothers, especially those with lower body weight or vitamin D deficiency, should be aware of this rare condition. Healthcare providers—including obstetricians, primary care doctors, and spine specialists—should consider this diagnosis when patients present with severe back pain during late pregnancy or lactation, particularly if standard treatments aren’t working. Women planning pregnancy who have risk factors (low body weight, vitamin D deficiency, or previous bone problems) should discuss prevention strategies with their doctors. This condition is rare, so most pregnant and breastfeeding women do not need to worry, but awareness can lead to earlier diagnosis if it does occur.

Pain relief may begin within weeks to months after starting appropriate treatment, as seen in this patient. However, rebuilding bone strength is a much slower process that can take many months to years. In this case, significant bone density improvement was not observed even after 19 months of treatment. Patients should expect gradual improvement in symptoms but should be prepared for a long recovery period. Regular follow-up with healthcare providers is important to monitor progress and adjust treatment as needed.

Want to Apply This Research?

  • Track back pain intensity daily using a 0-10 pain scale, along with breastfeeding status (yes/no) and calcium/vitamin D supplement intake. This helps identify patterns and monitor whether treatments are working over time.
  • If diagnosed with this condition, use the app to set reminders for taking calcium and vitamin D supplements consistently, track compliance with wearing supportive bracing, and log any physical activities that trigger pain. Share this data with your healthcare provider at appointments to guide treatment adjustments.
  • Create a monthly summary view showing pain trends, supplement adherence, and any new symptoms. Set quarterly check-in reminders to review progress with your doctor, including scheduled bone density testing. Track any changes in breastfeeding status and correlate with pain or symptom changes to identify triggers.

This case report describes the experience of one patient and should not be considered medical advice for your individual situation. Pregnancy and lactation-associated osteoporosis is a rare condition that requires professional medical diagnosis and treatment. If you experience severe back pain during pregnancy or breastfeeding, consult with your healthcare provider immediately for proper evaluation. Do not stop breastfeeding or start any new medications without discussing with your doctor first. The treatments described in this case may not be appropriate or effective for everyone. Always work with qualified healthcare professionals, including your obstetrician and possibly a bone specialist, to develop a treatment plan tailored to your specific needs and medical history.