Receding gums, weak grip strength, and neck or back pain are all symptoms of osteoporosis. Talk with a doctor if you suspect you have osteoporosis. They can perform a bone density test to confirm your diagnosis.

Osteoporosis is a condition that causes your bones to become thinner, weaker, and more brittle. According to the International Osteoporosis Foundation, it affects 21.2 percent of women over age 50 and 6.3 percent of men over the same age across the world.

An illustration depicting the difference between normal, healthy bone and osteoporosis. Share on Pinterest
Illustration by Wenzdai Figueroa

Although your bones are very strong, they consist of living tissue that continually breaks down and rebuilds. Up until your early 20s, your body has the ability to make new bone faster than it breaks down old bone tissue. But this process slows down as you get older.

As you age, old bone tissue can break down faster than its created. This can cause your bones to become more porous and fragile, resulting in osteoporosis, which can increase your risk of bone fractures.

Learning about symptoms and risk factors can help keep your bones strong throughout your life.

Treating osteoporosis in its earliest stages is the best way to prevent some of the more serious consequences, such as bone fractures or bone pain.

So what types of symptoms should you be on the lookout for, and when do they develop? Let’s look more closely at what’s known about the symptoms of osteoporosis in the early and later stages.

Signs and symptoms of early-stage osteoporosis

Early, detectable signs of bone loss are rare. Often people don’t know they have weak bones until they’ve broken their hip, wrist, or some other bone.

However, some signs and symptoms can point toward potential bone loss, such as:

  • Receding gums. Your gums can recede if your jaw is losing bone. Ask your dentist to screen for bone loss in the jaw.
  • Weaker grip strength. In a study of postmenopausal women and overall bone mineral density, researchers found that low handgrip strength was linked to low bone mineral density. In addition, lower grip strength can increase your risk for falls.
  • Weak and brittle fingernails. Nail strength can signal bone health. But you should also take other factors into consideration that may affect your nails, such as exposure to very hot or cold temperatures, regular use of nail polish remover or acrylic nails, or submersion in water for long periods of time.

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 to talk with your doctor or healthcare professional, especially if you have a family history of osteoporosis.

Signs and symptoms of later-stage osteoporosis

Once bone mass has deteriorated further, you may start to experience more obvious symptoms, such as:

  • Loss of height. Compression fractures in the spine can cause you to become shorter. 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 from 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 fracture. The compression of the vertebrae may also cause a slight curving of the upper back. A stooped back is known as kyphosis, which can cause back and neck pain. It can even affect breathing due to the extra pressure on the airway and limited expansion of your lungs.

Both men and women can develop osteoporosis, but this condition is more common in women because it’s often caused by hormonal shifts that occur with aging.

Common risk factors for osteoporosis include:

  • older age
  • going through menopause before age 45
  • 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 weight-bearing exercise like walking

According to research, osteoporosis is more prevalent in white people and people of Asian descent, more specifically women.

Certain medical conditions may also increase your risk for osteoporosis. These include:

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. The test takes anywhere from 10 to 15 minutes.

Another type of imaging study that doctors may use to diagnose or confirm a diagnosis of osteoporosis includes using ultrasound, usually of a person’s heel.

A doctor can interpret the results and will let you know if your bone density is considered normal or below average per industry guidelines.

Sometimes a doctor will give a diagnosis for osteopenia, or low bone mass. This is not osteoporosis yet. It means that your bones are not as dense as they should be.

Osteoporosis can increase the risk for bone fractures, particularly fractures of the wrist, spine, or hip.

According to the International Osteoporosis Foundation, globally 1 in 3 women and 1 in 5 men, over age 50, will experience osteoporosis fractures.

The effects of spinal fractures can cause a person to become shorter because these fractures can shorten the spinal column. In some instances, bone fractures may require surgery.

According to research, bone fractures can increase your risk of disability or death. Hip fractures, in particular, are associated with a 15 to 20 percent increase in mortality within a year, especially among men.

Osteoporosis can also cause bone pain that can affect your ability to perform daily activities.

Treatment for osteoporosis includes medications to help build bone mass. These 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:

  • bisphosphonates
  • calcitonin
  • estrogen
  • parathyroid hormone (PTH), such as teriparatide
  • parathyroid hormone-related protein, such as abaloparatide
  • raloxifene (Evista)

Romosozumab (Evenity) is a newer medication that the Food and Drug Administration approved in April 2019 to treat osteoporosis in women who have gone through menopause and are at a high risk of experiencing fractures.

It has a boxed warning because the medication may increase the risk of heart attacks or strokes. It’s not recommended for people with a history of these conditions.

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. The balloon is replaced by cement that makes the bone strong again.

It’s important to take action to prevent bone loss and maintain bone density.

Examples of bone-building steps you can take include the following:

Engage in exercise

Regular weight-bearing exercises help to build bone mass. Weight-bearing exercise involves physical activity that you do on your feet, with your weight supported by your bones. Examples include:

Eat enough calcium

An adult typically needs about 1,000 milligrams (mg) of calcium per day, according to the National Institutes of Health. However, this may vary based on life stage and calcium needs.

Foods that are rich in calcium include:

  • low fat dairy products
  • canned sardines and salmon (with bones)
  • broccoli
  • beans or legumes
  • collard greens
  • kale
  • bok choy
  • fortified foods, such as bread, cereal, and almond milk

For specific information about your calcium needs, talk with a healthcare professional.

Get enough vitamin D

Get vitamin D on a daily basis. Vitamin D is vital to helping your body absorb calcium. Most people need 400 international units (IU) of vitamin D each day.

Between 10 and 15 minutes of sun exposure can stimulate vitamin D production. Spending this limited amount of time in the sun two to three times a week while wearing sunscreen is enough to meet your vitamin D needs, per the Skin Cancer Foundation.

Foods such as fortified milk, egg yolks, and salmon also have vitamin D.

Prevent falls

You can help 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
  • removing clutter from areas where you walk

Ways to help prevent falling outdoors include:

  • using supportive devices like a cane or walker
  • wearing rubber-soled shoes with friction
  • walking on grass when the sidewalk is wet
  • salting or putting kitty litter over icy pavements

Wearing the right prescription glasses due to poor vision is also a helpful preventive measure.

Certain exercises can help with balance and grip strength as you walk around your home or outside. Consider making an appointment with a physical therapist to help you create a balance training program that’s tailored to your needs.

Avoid unhealthy substances

Smoking or having a substance use disorder, such as alcohol misuse, can increase your risk of osteoporosis.

Resources and support are available if you need help. For example, if you smoke, consider talking with your doctor about the best way to quit, smoking aids that may help, or other supportive resources.

Osteoporosis symptoms can cause pain and discomfort. It’s important to make an appointment with a doctor immediately if you are experiencing severe pain, particularly in your back, neck, hip, or wrist. You may have a fractured bone that requires evaluation and treatment.

If you need help finding a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.

Osteoporosis is a condition that causes your bones to become thinner and more brittle. Because your body’s ability to make new bone slows down as you get older, osteoporosis is much more prevalent in older adults. Although osteoporosis is more common in women, it can affect men, too.

Osteoporosis typically doesn’t have symptoms. You may not know you have this condition until you’ve broken a bone. However, some signs and symptoms, such as receding gums, weaker grip strength, and more brittle fingernails may be early warning signs.

A loss of height, a stooped posture, back or neck pain, and bone fractures are often the most common symptoms of later-stage osteoporosis.

If you have any of these symptoms, be sure to make an appointment with your doctor. They can diagnose osteoporosis with the help of certain tests and create a treatment plan that’s right for you.

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