Symptoms of Osteoporosis

A bone disease that makes you vulnerable to fractures

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Osteoporosis is often called a "silent disease" because it causes few to no symptoms. Osteoporosis chronic disease by which there is a gradual deterioration of the tissue that comprises your bones. The pace of new bone formation cannot keep up with bone loss, which can occur due to age, hormonal changes, medication use, and other causes. Over time, the reduction in bone mass weakens the skeleton, making bones weak, fragile, and more porous—and more prone to fracture.

Unlike many other bone diseases, osteoporosis can be prevented or at least slowed down through exercise, eating nutritiously, avoiding smoking, and limiting alcohol intake.

Frequent Symptoms

Osteoporosis does not cause any symptoms until a fracture occurs, and even then, some people are unaware they broke a bone, especially if it occurs within the spine.

That said, there are some signs that indicate you should be tested for osteoporosis.

Symptoms of Osteoporosis

  • Low-energy fractures
  • Height loss or stooped posture
  • Pain or aching in the bones/joints
  • Sudden back pain
  • No symptoms at all

Low-Energy Fractures

Most everyone has had a broken bone, but usually, there is a major force that causes the injury. Fractures after a fall from a height, car crashes, or sports injuries make sense. But when you break a bone with minimal force, osteoporosis should be considered.

Height Loss or Stooping

Compression fractures of the spine may go undetected or be attributed to a back strain type of injury. When multiple vertebrae are injured, people may lose height or develop a curvature to their spine. The typical appearance of an individual with compression fractures is a short stature with a humped back.

Unexplained Bone or Joint Pain

There are many causes of bone and joint pain, but osteoporosis may contribute to these symptoms. When the bones lack sufficient strength to hold the weight of your body, injury can occur. Unexplained bone or joint pain may raise the consideration of a bone health problem.

Sudden Back Pain

Back pain that comes on suddenly, with no apparent cause, can sometimes be a sign of a compression fracture of the spine. It's easy to chalk up back pain to a pulled muscle, but if you have risk factors of osteoporosis and you're experiencing back pain to which you can't pinpoint a cause, it's a good idea to have it checked out.

No Symptoms at All

Again, osteoporosis is called a silent disease because of the fact you often have no symptoms and not know you have it until a fracture occurs.

Because of that, it's important to know your risk factors for developing osteoporosis. Examples of such risk factors that are not within your control include:

  • Being female
  • Caucasian race
  • A family history of osteoporosis
  • Natural or surgical menopause before the age of 45

Advancing age, having an underlying health condition, or taking a medication that makes you more vulnerable to developing osteoporosis, are other factors that increase your risk for developing osteoporosis.

In the end, the more risk factors you have, the more likely it is that you will develop osteoporosis.

There are also several lifestyle risk factors that you have the power to influence. Minimizing or eliminating these can reduce your risk of developing osteoporosis:

  • Smoking
  • Excessive alcohol or caffeine consumption
  • Low body weight (less than 127 pounds)
  • Inadequate calcium or vitamin D intake
  • Sedentary lifestyle

Rare Symptoms

There are a few other signs that you may be experiencing loss of bone density.

Loss of Grip Strength

There's increasing evidence that a loss of grip strength is a good predictor of osteoporosis. This could be attributed to other issues, like osteoarthritis for example, but should be brought to your doctor's attention nonetheless.

Loss of Fitness

This may be a bit of a chicken-or-the-egg situation, but an overall loss of fitness is tied to osteoporosis. Another important reason to exercise regularly, especially as you age.

Periodontal Disease

Some research suggests an association between periodontal disease (receding gums, tooth loss, etc.) and osteoporosis. Other studies have found, though, that the association isn't significant. Certain osteoporosis treatments can adversely affect oral health, so it's important to discuss this potential side effect with your doctor.

Complications

The most obvious complication of osteoporosis is bone fractures. These can be very serious, especially fracture of the spine or hip, and can have serious health implications.

Fragility Fracture

A fragility fracture results from mechanical forces that otherwise would not normally cause a fracture. For example, a fall from a standing height or less should not result in a fracture, but it may in a person with osteoporosis.

Avoiding Falls

Most osteoporosis-related fractures occur as the result of falls around the house.

Fortunately, there are steps you can take to prevent these injuries. Some include:

  • Asking your doctor about medications you are taking and whether or not they may lead to falls
  • Considering a home safety assessment where interventions can be implemented (e.g., installing stair handrails, placing a non-slip bath mat, and improving lighting, to name a few)
  • Performing 30 minutes of weight-bearing exercises most days of the week
  • Performing muscle-strengthening exercises two to three days a week
  • Having your vision evaluated regularly

When to See a Doctor

The diagnosis of osteoporosis can be made one of two ways: either by the presence of a fragility fracture—especially at the spine, hip, wrist, humerus (upper arm), rib and pelvis—or through bone mineral density testing. If you notice any symptoms of osteoporosis, or if you have many risk factors, the best thing you can do is to get screened.

Screening

Screening for osteoporosis and catching it early or while your bones are osteopenic is key to reducing your risk for developing fractures.

The National Osteoporosis Foundation recommends screening for osteoporosis with a bone mineral density test for the following groups of people:

  • Women age 65 or older
  • Women under the age of 65 with risk factors for osteoporosis (see above)
  • Men age 70 or older
  • Men under the age of 70 with risk factors for osteoporosis
  • Anyone who has broken a bone after age 50

Bone Mineral Density Testing

Bone mineral density (BMD) testing is done with a dual energy X-ray absorptiometry (DEXA) scan, also known as bone densitometry or DXA—a special type of low-radiation X-ray that can detect very small percentages of bone loss in the spine and hip.

Osteoporosis is diagnosed when a person's BMD is 2.5 or more standard deviations (SDs) below the bone mineral density of a healthy 30-year old adult. (This is called a T-score.)

Key Point

Being diagnosed with osteoporosis by DXA scan does not mean you have or will definitely develop a fracture. Rather, it means your bone mass is low enough to make you susceptible to fracturing.

Once diagnosed with osteoporosis, either through a DXA scan or by the presence of a fragility fracture, your doctor will likely order several blood tests to determine if there is a secondary cause for your osteoporosis, and to see if there are any contraindications to taking an osteoporosis medication.

Some of the key laboratory tests usually ordered include:

Optimizing Bone Health

Besides exercises, strengthening your bones through nutrition is another important component for preventing osteoporosis and subsequent bone fractures.

Consider seeing a dietitian to optimize your calcium intake from food (which is preferred over taking supplements) based on your age and gender. For example, men should consume at least 1000 milligrams (mg) of calcium daily, while postmenopausal women should consume 1200 mg of calcium daily.

In addition, talk with your doctor about having your vitamin D level checked and if low, consider a vitamin D supplement.

Other steps to optimize your bone health include:

  • Avoid smoking
  • Avoid excessive alcohol consumption
  • Limit caffeine to no more than 2.5 units daily (1 unit is equal to one cup of coffee or two cups of tea)

A Word From Verywell

Osteoporosis is an asymptomatic disease until a fracture occurs, which can cause pain and sometimes significant disability. Remain an advocate for your bone health: In addition to making lifestyle efforts, discuss your osteoporosis risk factors and whether or not you need a bone density test with your doctor.

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