Work up with DEXA, CMP, TSH, Vit D. If suspect malignancy, check CBC, Alk Phos. SPEP and UPEP and CRP and bone scan. Treat with Tylenol 650 mg bid or Naproxen 500mg bid. If persistent pain consider Calcitonin 200 U spray, and if pain > 3 mo consider MRI to look for bone marrow edema and consideration for vetebroplasty.