Although your bones are usually very strong, they consist of living tissue that continually breaks down and rebuilds.
As you age, it’s possible for old bone to break down faster than the building of new bone. This causes your bones to have holes and become more fragile. This is called osteoporosis.
Treating osteoporosis in its earliest stages is the best way to prevent some of the more serious consequences, such as loss of height or bone breakages. Learning about symptoms and risk factors can help you can take the right steps to keep your bones strong.
Early, detectable signs of bone loss are rare. Often people don’t know they have weak bones until they’ve broken their hip, spine, or wrist. Some signs and symptoms can point toward bone loss, however:
Your gums can recede if your jaw is losing bone. Ask your dentist to screen for bone loss in the jaw.
Weaker grip strength
Weak and brittle fingernails
Nail strength can signal bone health. But you should also take into consideration outside factors such as swimming, gardening, and other exercises that may affect your nails.
Other than changes in bone density, osteoporosis doesn’t usually cause a lot of initial symptoms. Your best bet for detecting it in the early stages is going to the doctor, especially if you have a family history of osteoporosis.
When the bone has deteriorated significantly more, you may start to experience more obvious symptoms, such as:
Loss of height
Compression fractures in the spine can cause a loss of height. This is one of the most noticeable symptoms of osteoporosis.
Fracture from a fall
A fracture is one of the most common signs of fragile bones. Fractures can occur with a fall or a minor movement such as stepping off a curb. Some osteoporosis fractures can even be triggered by a strong sneeze or cough.
Back or neck pain
Osteoporosis can cause compression fractures of the spine. These fractures can be very painful because the collapsed vertebrae may pinch the nerves that radiate out from the spinal cord. The pain symptoms can range from minor tenderness to debilitating pain.
Stooped posture or compression fracture
The compression of the vertebrae may also cause a slight curving of the upper back. A stooped back is known as kyphosis.
Kyphosis can cause back and neck pain and even affect breathing due to extra pressure on the airway and limited expansion of your lungs.
Osteoporosis symptoms can cause pain and discomfort. See a doctor immediately if you are experiencing severe pain, particularly of the back, neck, hip, or wrist. You may have a fractured bone that requires evaluation and treatment.
Both men and women can get osteoporosis, but this condition is more common in women because it’s often caused by hormonal shifts that occur with aging. When your body breaks down your bone tissue faster than it can create more, it causes osteoporosis.
Common risk factors include:
- older age
- going through menopause before age 45
- being of Caucasian or Asian decent
- having ovaries removed before age 45
- having low testosterone in men
- having low estrogen in women
- taking certain medications that decrease hormone levels
- smoking cigarettes
- having a family history of osteoporosis
- drinking alcohol frequently
- not getting enough regular physical activity, particularly strength-training exercise
Having certain medical conditions can also increase your risk for osteoporosis. These include:
- kidney failure
- multiple sclerosis
- rheumatoid arthritis
Taking immunosuppressive medications and steroids, like prednisone, can also increase your risk for osteoporosis. Seizure medications and thyroid replacement therapy (if dosage is too high) can increase this risk as well.
Your doctor may detect osteoporosis by measuring your bone density. A machine called a dual energy X-ray absorptiometry, or DXA machine, can scan your hip and spine to determine how dense your bones are compared to other people of your gender and age.
The DXA scan is the primary diagnostic method, and it takes anywhere from 10 to 15 minutes.
Other imaging studies that doctors use to diagnose or confirm a diagnosis include:
- ultrasound, usually of a person’s heel
- quantitative CT scan of the lower spine
- lateral radiographs, which are conventional X-rays
A doctor can interpret the results, letting you know if your bone density is normal or below normal. Sometimes a doctor will give a diagnosis for osteopenia, or low bone mass. This isn’t osteoporosis yet. It means that your bones aren’t as dense as they should be.
Osteoporosis can increase the risk for bone fractures, particularly for the wrist, spine, or hip. The effects of spinal fractures can cause a person to become shorter because fractures can shorten the spinal column. In some instances, bone fractures may require surgery.
Osteoporosis can also cause bone pain that can affect a person’s ability to perform daily activities. Fractures can increase your risk for disability or death, according to the Mayo Clinic.
Treatment for osteoporosis includes medications to help build bone mass. The medications often have hormonal influences, stimulating or acting like estrogen in the body to encourage bone growth. Examples of medications used to treat osteoporosis include:
- parathyroid hormone (PTH), such as teriparatide
- parathyroid hormone-related protein, such as abaloparatide
- raloxifene (Evista)
Romosozumab (Evenity) is a newer medication that was approved by the FDA in April 2019 to treat women who have gone through menopause and are at a high risk of having fractures. It has a “black box” warning because the Evenity may increase the risk of heart attacks or strokes, so it’s not recommended for people with a history of either.
Kyphoplasty is a surgical treatment for fractures. Kyphoplasty involves using small incisions to insert a small balloon into the collapsed vertebrae to restore height and function to the spine.
It’s important to take action to prevent bone loss and maintain bone density.
Examples of bone-building steps you can take include:
Engaging in exercise
Regular weight-bearing exercises help to build bone mass. Examples include weightlifting, dancing, jogging, or racquet sports like tennis.
Low-impact exercises like walking or using an elliptical machine are important to an overall healthy exercise program, but they don’t provide enough resistance to build stronger bones.
Eating enough calcium
On a daily basis, an adult needs about 1,000 milligrams (mg) of calcium per day until they’re 65 years old. After that, calcium needs often increase to between 1,200 and 1,500 mg. Foods that are rich in calcium include:
- low-fat dairy products
- canned sardines and salmon (with bones)
- beans or legumes
- collard greens
- bok choy
- fortified foods, such as bread, cereal, and almond milk
Getting enough vitamin D
Get vitamin D on a daily basis. Vitamin D is vital to helping the body absorb calcium. Most people need 400 international units (IU) of vitamin D each day.
About 15 minutes of daily sun exposure can stimulate vitamin D production. Foods such as fortified milk, egg yolks, and salmon also have vitamin D.
Avoiding unhealthy substances
Smoking or drinking excessive amounts of alcohol increases risk for osteoporosis.
You can prevent falling indoors by:
- wearing nonslip shoes and socks
- keeping electrical cords against the edges of your walls
- keeping rooms brightly lit
- making sure the carpets are tacked to the floor
- keeping a flashlight next to your bed
- putting grab bars in the bathroom
Ways to prevent falling outdoors include:
- using support like a cane or walker
- rubber-soled shoes with friction
- walking on grass when the sidewalk is wet
- salting or putting kitty litter over icy pavements
You can also make sure you are wearing the right prescription glasses to prevent falls due to poor vision.
Certain exercises can help with balance and grip strength as you walk around your home or outside. See a physical therapist for help creating a balance training program.