If you experience risk factors for osteoporosis— for instance, if you’re close to menopause as a woman, have taken glucocorticoids for more than three months, or having calcium or vitamin D-deficiency — don’t wait until you experience symptoms to get checked.
“Osteoporosis is an asymptomatic condition until you experience a fracture,” explains endocrinologist Geetha Gopalakrishnan, MD, an assistant professor of medicine in the division of endocrinology, diabetes, and metabolism at Brown University School of Medicine in Providence, Rhode Island. No matter where the fracture was, your wrist, hip, or spine, if you have osteoporosis, it could have happened because you fell or simply bumped into something in a way that, when you were younger, would probably not have harmed your bones.
Fractures due to osteoporosis are dangerous in terms of time and money as well being a serious health threat. They tend to require a longer hospital stay than for most other conditions that require hospitalization among seniors, and have the highest medical expense, according to a health data analysis by a team of researchers at East Virginia Medical School published in 2016 in Osteoporosis International.
If you can recognize bone loss early, you can make moves to reduce your risk of osteoporosis.
Who Should Be Screened?
Men and women older than 50 should start talking to their doctor about their risk factors for osteoporosis to find out whether they need to be screened.
Generally, according to guidelines outlined in the 2014 issue of Osteoporosis International, people who should be screened for osteoporosis include:
- Adults who have a health condition that increases the risk of osteoporosis
- Adults who are taking or have taken medications that can increase osteoporosis risk, such as steroids, contraceptives given by injection, or some cancer treatments
- Women older than 65
- Men older than 70
- Any adult who has had a fracture after age 50
- Women who have more than one risk factor other than being Caucasian or postmenopausal (for example, a family history of osteoporosis and low body weight)
Because bone loss begins without noticeable symptoms, screening should ideally occur before you have reason to worry.
Fracture: The Most Common Early Symptom
You may have a fragility-related fracture before you are diagnosed with bone loss or osteoporosis. This means that your wrist, back, hip, or another bone is fractured as a result of a mild to moderate trauma, such as falling from below your standing height. Mild impact caused by tripping, falling, or hitting an object that might not have fractured or broken a bone in previous years can cause future fractures when you develop bone loss or osteoporosis. If you experience this kind of fracture and are older than 50, the National Institutes of Health (NIH) recommends talking to your doctor about bone-loss screening or other tests for bone loss. Depending on the results, you may need to discuss treatment options that can help reduce bone loss.
When researchers looked at the records of 47,171 women, most in their early 60s, who had a fragility fracture, they found that only about one in five knew they had osteoporosis beforehand. For the majority, the fracture prompted them to talk to a doctor about bone health. Yet, according to the report, which was published in 2014 in Osteoporosis International, very few of the women started follow-up treatment designed to prevent another fracture.
How do you know if you’ve experienced a fragility-related fracture? Sometimes they’re obvious — you’ll experience pain and swelling immediately after a fall or impact, even one that you wouldn’t think could hurt you. The American Academy of Orthopedic Surgery points out that you also might notice that the affected area looks out of alignment, caused by the fracture. In other instances, you may feel pain, such as in your back, but not be able to trace it to a single event. Back pain can also be a result of a vertebral fracture, in which the pain may last as long as six weeks while your bones heal. If you suspect that a fracture is possible, see your doctor.
Other Early Signs of Osteoporosis
Certain physical changes can signal osteoporosis. A loss of height or change in posture, such as stooping over, can be signs that you might have osteoporosis, according to the NIH. Guidelines encourage doctors to measure the height of their patients regularly to monitor changes that occur with age. Ask for your measurement at every wellness checkup.
“If you have a height loss of more than two inches or you have curvature of the spine, these are symptoms to pay attention to,” Dr. Gopalakrishnan says. These changes suggest that osteoporosis is affecting your vertebrae.
Other signs or conditions also can mean you’re at a higher risk for a bone fracture, including:
- High levels of serum calcium or alkaline phosphatase on a blood test
- Bone mineral density results showing a T-score of -2.5 or less (the T-score indicates whether your bone density is above or below average, and a score -2.5 or less indicates osteoporosis)
- Vitamin D deficiency
- Difficulty getting up from a chair without using your arms to push
- Joint or muscle aches
These symptoms can relate to other health problems as well, so it’s vital to talk to your doctor so you can get a correct diagnosis and proper treatment. Remember that aches and pains are not unusual as you get older, Gopalakrishnan says, and most of them do not mean you have osteoporosis. But, to be sure, don’t hesitate to bring up any noticeable pain you’re feeling.