Osteoporosis typically does not cause any symptoms until a person has a fracture. For this reason, some refer to it as a silent disease. The condition involves a gradual decrease in bone density.

This loss of density is not painful and usually does not come with any other noticeable symptoms.

In some cases, though, a person may have symptoms that result from an undiagnosed fracture or the underlying cause of their osteoporosis.

In this article, we will discuss the symptoms of osteoporosis, its stages, causes, and diagnosis.

A person with a broken arm in a blue cast due to osteoporosis.Share on Pinterest
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Osteoporosis does not usually cause symptoms unless a person has a fracture. There are no early warning signs as there are with some other conditions.

The only exception to this are symptoms of an undiagnosed fracture. If a person has experienced bone fractures without realizing it, this may cause pain and changes in mobility. If the fractures occur in the spine, their posture and height may change.

As osteoporosis can be a silent disease, it is important that people take steps to help prevent it from as early an age as possible and get screened for the condition if they are at risk.

A doctor can check for osteoporosis with a bone mineral density test. This measures the amount of calcium and other minerals in the bone.

For a person who is either postmenopausal or over the age of 50 years, the results of a bone mineral density test will have a T-score, which signifies how severe the mineral loss is. Doctors measure the T-score by calculating the difference between a person’s bone density and 0, which represents the bone density of a young adult.

The scores are:

  • 1 or more: This indicates the bone is healthy — breaking down and growing back at a stable rate.
  • Between -1 and -2.5: This indicates osteopenia, which is a decrease in density that is not as severe as osteoporosis. A person with this score has weakened bones that may be at risk of fractures.
  • Less than -2.5: This indicates osteoporosis.

For premenopausal females and people under the age of 50 years, doctors use a Z-score instead. This measures the difference between a person’s own bone density and the bone density of others their age, sex, or ethnicity. If the Z-score is -2.0 or less, this means a person may have low bone density.

There are usually no early symptoms of osteoporosis. A person will not feel the drop in their bone density unless they experience a fracture.

However, a person may have symptoms of other conditions that can lead to osteoporosis. For example, if the cause is a calcium deficiency, a person may have:

However, the exact symptoms will depend on what is causing the loss of bone density.

As osteoporosis progresses, the bones get brittle and more fragile. A knock, or even a sneeze or cough, can cause a bone to break.

If a person has fractures in the spine, this can cause severe pain as well as changes in posture. A person may develop kyphosis, or a curved spine, and could lose height.

Bone is a type of tissue that is constantly breaking down and repairing itself. In children and young adults, new bone builds faster than it breaks down, which means bones gradually get stronger over time.

Bone density reaches its peak when a person is between the ages of 20 and 30 years. As a person ages, the body does not replace the bone that breaks down at the same rate, gradually reducing bone density.

Not everyone develops osteoporosis as they get older, though. This occurs when bone breaks down faster than it can rebuild, resulting in fragile bones.

Many medical conditions, medications, and risk factors can elevate the chances a person will develop osteoporosis. These include:

  • older age
  • family history of fractures or osteoporosis
  • having fractures after the age of 50 years
  • physical inactivity or prolonged bed rest
  • smoking or excessive alcohol use
  • low estrogen levels in females
  • low testosterone levels in males
  • having a low body mass index
  • vitamin D or calcium deficiencies
  • current or previous eating disorders
  • malnutrition
  • long-term use of medications that affect mineral levels, such as proton-pump inhibitors and corticosteroids
  • autoimmune disorders such as rheumatoid arthritis and celiac disease

Doctors diagnose osteoporosis with a bone mineral density test. Most commonly, they use a test known as central dual-energy X-ray absorptiometry (DXA).

During the test, a health professional will use a special X-ray to measure the amount of calcium and other minerals in a specific part of the skeleton, such as the hip or spine.

Other tests include:

  • Peripheral DXA: This measures bone density using a portable device, often by measuring the wrist or ankle. It is less accurate than DXA.
  • Quantitative ultrasound of the heel: This predicts a person’s risk of broken bones. It does not measure bone density, though.

Anyone who is concerned they may be at risk of osteoporosis, or that they may have the condition, should speak with a doctor as soon as they can.

The U.S. Preventive Services Task Force recommends that all females over age 65 years receive bone health screening. Currently, there is no recommendation in place for other sexes, but as anyone can develop osteoporosis, older people who have concerns should ask their doctor about regular screening.

The frequency of bone mineral density testing will depend on a person’s age, their risk factors, and the results of previous tests, if they have had any.

Osteoporosis is known as a silent disease because it does not typically cause any symptoms. It occurs due to a loss of bone density, which happens gradually over time. Many people only find out they have osteoporosis when they have a fracture.

Many factors can increase a person’s risk of developing osteoporosis, including older age, vitamin D deficiency, calcium deficiency, and certain medications. A doctor can screen a person to better understand their bone health and risk of fractures.