Osteoporosis symptoms & treatment

Your bones are made up of living, growing tissue. As old bone tissue dies, your body constantly makes new, strong bone tissue. With osteoporosis, old bone is not replaced by new bone fast enough, causing a decrease in bone mass and density.

Over time, the bones become weak and brittle and may fracture easily – even from lightly bending, lifting, coughing or a minor fall. Osteoporosis is called a “silent” disease because most people who have it don’t have any symptoms.

The four stages of osteoporosis

Osteoporosis develops gradually – in four stages over many years – and it’s often not diagnosed until you break a bone.

Stage 1. From about ages 20-40, bones break down at the same rate new tissue forms. This is considered the first stage of osteoporosis because bone growth is no longer faster than bone loss like it is from birth through adolescence. There are no symptoms at this stage, and bone density T-score will be in the normal range, from +1 to –1.

Stage 2. At this stage bone loss begins to outpace bone growth. If you have an injury or get bone density testing done for another reason, you might be diagnosed with osteopenia, or slight bone loss. T-scores at this stage range from -1 to -2.5.

Stage 3. If you reach this stage, you officially have osteoporosis. You still might not notice any symptoms, but you’ll be at increased risk for breaks and fractures – even from simple injuries like hitting your leg against a door. At this stage T-scores are -2.5 or lower.

Stage 4. This is the most severe form of osteoporosis. Outside of breaks and fractures, this is the only stage where you can actually see bone loss. Softer and weaker bones can show in the form of spinal deformities such as a bent-over appearance called kyphosis and pain with everyday activities. At this stage T-scores are well below -2.5 and most people have had one or more bone breaks or fractures.

Osteoporosis symptoms

Symptoms of osteoporosis may include:

• A stooped or curved posture (kyphosis) when sitting or standing
• Height loss over time
• Collapsed or fractured vertebra(e)
• Bones that fracture easily
• Back pain

You may not notice any symptoms until you already have significant bone loss.

Are you concerned about back pain?

Back pain can interrupt even the simplest things in life, and lasting or severe discomfort along your spine could point to a serious problem. Our back and neck pain quiz helps evaluate your spine function, pain symptoms and risk factors and gives you an idea what to do next based on your results.

Osteoporosis causes and risk factors

The following can increase your risk for developing osteoporosis:

• Sex: Women are at greater risk for osteoporosis because they usually have smaller and less dense bones than men. Men are also at risk but are more likely to get osteoporosis after age 70.
• Age: New bone growth slows as you age. Over time, your bones can weaken, causing osteoporosis.
• Race: White and Asian people are at highest risk.
• Family history: Your risk for osteoporosis may increase if one of your parents has a history of osteoporosis or hip fracture.
• Hormones: Low levels of estrogen in women and testosterone in men can increase the risk of developing osteoporosis.
• Diet: A diet low in calcium and vitamin D, excessive dieting or poor protein intake can increase your risk for osteoporosis and fractures.
• Certain types of medical conditions: Endocrine and hormonal diseases, gastrointestinal diseases, rheumatoid arthritis, cancer, HIV/AIDS and anorexia nervosa can make you more likely to get osteoporosis.
• Physical activity: Low levels of physical activity and prolonged periods of inactivity can contribute to an increased rate of bone loss.
• Alcohol use: Chronic heavy drinking is a significant risk factor.
• Smoking cigarettes. Studies show that smoking is a risk factor for osteoporosis and fracture.

Osteoporosis diagnosis

Doctors usually diagnose osteoporosis during a routine screening for the disease. The U.S. Preventive Services Task Force recommends screening for:

• Women over age 65
• Women of any age who have broken a bone or fractured their spine or who have risk factors that increase the chance of developing osteoporosis

When you visit your doctor, remember to report:

• Any previous fractures
• Your lifestyle habits such as diet, exercise, alcohol use and smoking history
• Current or past medical conditions and medications
• Your family history of osteoporosis and bone fractures
• For women, your menstrual history

Your doctor may do a physical exam to check for:

• Loss of height and weight
• Changes in posture
• Balance and gait (the way you walk)

Testing may include:

• Blood work
• Dual-energy X-ray absorptiometry (DXA) to measure bone mass and thickness
• X-ray, MRI or CT scan to show any new or existing fractures

Osteoporosis prevention and treatment

The goals for treating osteoporosis are to slow or stop bone loss and prevent fractures. Treatments range from changes to your daily habits (to prevent bone loss or minimize it in early stages of osteoporosis) to spinal surgery to treat pain and repair bone damage in advanced stages.

Taking care of your bone health to prevent osteoporosis

• Doing weight-bearing exercise such as walking and lifting weights to increase strength, muscle mass, coordination and balance
• Drinking alcohol in moderation
• Not smoking
• Eating a nutritious diet rich in protein, calcium and vitamin D

Nonsurgical treatment for osteoporosis

• Fall prevention to help prevent fractures
• Calcium and vitamin D supplements
• Medications, if prescribed, for pain or to treat osteoporosis
• Physical therapy
• Weight loss

Surgical treatment for osteoporosis

• Spinal fusion surgery: Two vertebrae are permanently fixed together to reduce pain, increase spinal stability and stop the formation of bone spurs.
• Spinal nerve block: An anesthetic drug is injected near or directly into your spinal nerve. Spinal nerve blocks can provide pain relief and are sometimes used as a diagnostic tool to determine the source of your pain.
• Spinal stabilization: Your doctor implants rods, screws or locking plates in your spinal column. For less severe fractures, an orthotic vest or brace may be used instead.
• Vertebroplasty: Your doctor injects a medical-grade substance called bone cement, which "glues" the spine in its proper position to reduce pain and bone deformity.
• Kyphoplasty: First a balloon is inserted into the affected area to decompress your spine and allow you to regain lost height. Then your doctor will inject bone cement to stabilize your vertebrae.

Osteoporosis complications

In advanced stages, osteoporosis can cause other health conditions or occur along with conditions including:

• Cervical spinal stenosis and myelopathy (cervical spondylotic myelopathy): A narrowing of the spinal canal in the neck area, which may cause your spinal cord to become compressed or damaged. Symptoms may include pain, numbness, tingling, balance problems, muscle weakness and dizziness.
• Spinal compression fracture: A break or rupture in the vertebrae (the bones that make up the spine), sometimes referred to as collapsed vertebrae. The most common sign is severe back pain.
• Hypocalcemic tetany: A condition where extremely low blood levels of calcium (hypocalcemia) cause involuntary muscle contractions. If left untreated, it can lead to osteoporosis.
• Radiculopathy: Pressure on a nerve root that results in pain, weakness and numbness. Depending on the location of the nerve, you may also have difficulty controlling specific muscles.

Find spine care near you

When you have osteoporosis, we’re here to make it easier for you to get back to the things that matter most. With your own care coordinator, you’ll be connected to an integrated team of specialists all working together on your personalized treatment plan. Learn more about our spine services locations in eastern Wisconsin.

Aurora St. Luke’s Medical Center

Aurora BayCare Medical Center

Aurora Medical Center – Summit

Aurora Medical Center – Sheboygan County

Aurora Health Center – Burlington