What Are the First Signs of Osteoporosis?

Reviewed on 8/16/2021

Some of the first signs of osteoporosis may include the appearance of a widow's hump, a fractured wrist or hip from a fall, loss of height, change in posture, sudden back pain, cramps in the legs at night, abdominal pain, tooth loss, rib pain, broken bones, fatigue, gum (periodontal) disease, brittle fingernails, and visible spinal deformities.
Some of the first signs of osteoporosis may include the appearance of a widow's hump, a fractured wrist or hip from a fall, loss of height, change in posture, sudden back pain, cramps in the legs at night, abdominal pain, tooth loss, rib pain, broken bones, fatigue, gum (periodontal) disease, brittle fingernails, and visible spinal deformities.

Osteoporosis is a condition that occurs when the body loses too much bone, makes too little bone, or both, resulting in weak bones that can break (fracture) easily. 

The word osteoporosis means “porous bone.” Healthy bone looks like a honeycomb when viewed under a microscope. Bones affected by osteoporosis have larger holes and spaces than healthy bone. 

Women are at higher risk for osteoporosis when estrogen levels decline, which usually happens during menopause, but men can also get osteoporosis. 

Symptoms of osteoporosis often do not appear until there is significant and irreversible bone loss. Some of the first signs of osteoporosis may include: 

  • The appearance of a widow's hump 
  • A fractured wrist or hip from a fall 
  • Loss of height
  • Change in posture
  • Sudden back pain 
  • Cramps in the legs at night
  • Abdominal pain
  • Tooth loss
  • Rib pain
  • Broken bones
  • Fatigue
  • Gum (periodontal) disease
  • Brittle fingernails
  • Visible spinal deformities 

What Causes Osteoporosis?

The main cause of osteoporosis is a loss of estrogen in women, which often occurs during menopause and is why about 80% of all cases of osteoporosis occur in women. 

Other causes of osteoporosis include: 

SLIDESHOW

Osteoporosis Super-Foods for Strong Bones With Pictures See Slideshow

How Is Osteoporosis Diagnosed?

Screening for osteoporosis is recommended for women 65 years and older and for women under 65 who have gone through menopause and have risk factors for osteoporosis, such as past bone fractures, certain medical conditions, use of certain medications, smoking, or alcohol use. 

The FRAX tool is an osteoporosis risk assessment test that uses information about a patient’s bone density and other risk factors for breaking a bone to estimate their 10-year fracture risk. 

Screening for osteoporosis involves physical examination, patient history, and bone density tests. 

Tests used to diagnose osteoporosis include: 

  • Bone mineral density (BMD) test
  • Dual energy X-ray absorptiometry (DXA), a type of bone scan
  • Biochemical marker tests
  • X-rays
  • Vertebral fracture assessments (VFAs)

What Is the Treatment for Osteoporosis?

Treatment for osteoporosis usually includes medication or hormonal therapy. 

Medications used to treat osteoporosis include: 

  • Bisphosphonates
  • Selective estrogen receptor modulators (SERMs)
    • Produces some estrogen-like effects in the bone and provides protection against postmenopausal bone loss
  • Hormone therapy with estrogen or estrogen-progestin 
    • Estrogen is not recommended to treat or prevent osteoporosis in postmenopausal women but it may be used to prevent osteoporosis in young women whose ovaries do not make estrogen
  • Denosumab (Prolia) 
    • An antibody that works to improve bone mineral density and reduce fractures in postmenopausal women with osteoporosis
  • Calcitonin 
    • No longer used to treat osteoporosis, but due to its pain-relieving effects it may be used for short-term therapy for acute pain due to vertebral fractures
  • Anabolic agents 
    • Only recommended for severe osteoporosis
  • Parathyroid hormone/parathyroid hormone-related protein 

What Are Complications of Osteoporosis?

Complications of osteoporosis include: 

  • Bone fractures
    • Most likely to occur in the hip, spine, or wrist, but may occur in other bones 
    • 20% of seniors who break a hip die within one year from complications related to the broken bone itself or the surgery to repair it
  • Permanent pain
  • Loss of height
  • Stooped or hunched posture
  • Limited mobility, which can lead to feelings of isolation or depression
  • Need for long-term nursing care

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Reviewed on 8/16/2021
References
https://www.nof.org/

https://www.uptodate.com/contents/osteoporosis-prevention-and-treatment-beyond-the-basics?search=osteoporosis&topicRef=15482&source=see_link

https://www.ucsfhealth.org/conditions/osteoporosis/symptoms

https://www.menopausenow.com/osteoporosis/about