Recognizing the Early Signs of Osteoporosis

• By Madeline Vann, MPH | Medically reviewed by Lindsey Marcellin, MD, MPH

If you have risk factors for osteoporosis – meaning you’re a postmenopausal woman or you’re vitamin D-deficient, among others – don’t wait until you have symptoms to get screened. The fact is, bone loss that leads to osteoporosis often occurs without any noticeable symptoms, so by the time you have a fracture, feel pain, or develop curvature of the spine, osteoporosis may already be present.

But if you identify bone loss early, you can take steps to reduce your risk of osteoporosis.

When to Get Screened for Bone Loss

Studies suggest that only 12 percent of people with osteoporosis have had abone mineral density (BMD) screening, the most reliable diagnostic test for osteoporosis. This is likely due to a lack of awareness among middle-aged and older women and their physicians about the risk of osteoporosis. The most common type of screening for BMD is referred to as a DXA or DEXA (dual x-ray absorptiometry) scan, a painless procedure using very low levels of radiation to measure the density of bone in your hip, spine, or other areas.

Who Should Get Screened for Bone Loss

In general, people who should be screened for osteoporosis include:

Women over age 65

Women who have more than one risk factor (for example, a family history of osteoporosis or low body weight) other than being Caucasian or past menopause

Postmenopausal women who have had a fracture

Since bone loss begins without any noticeable symptoms, screening should ideally occur before you have reason to worry.

Fracture: The Most Common Early Osteoporosis 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 fractures when you have bone loss or osteoporosis. If you experience this kind of fracture and are over 50 years old, talk to your doctor about bone-loss screening or other tests for bone loss.

A study of 127 people who had a fragility-related fracture showed that only 17 percent thought their fracture could be related to osteoporosis and fewer than half believed they were at increased risk for another fracture, even though having one fracture significantly increases the risk of later fractures. Osteoporosis was diagnosed in 44 percent of these patients, and the patients who reported understanding the connection between osteoporosis and fracture had already been told they might be at risk.

Having any of these signs or conditions means you are at higher risk for a bone fracture:

High levels of serum calcium or alkaline phosphatase on a blood test

Vitamin D deficiency

Difficulty getting up from a chair without using your arms to push

Joint or muscle aches

A resting pulse greater than 80 beats per minute

Height loss

Increasing stooping (curvature of the spine)

BMD results of -2.5 or less

These symptoms can indicate other health problems as well, so it’s important to talk to your doctor about them to get an accurate diagnosis and treatment plan.

Fragility Fracture Symptoms

You might wonder if you have experienced a fragility related fracture. Sometimes they're obvious and you will experience pain and swelling immediately after a fall or impact. At other times, you may feel pain, such as in your back, but not be able to trace it to a single event. Nonetheless, back pain can be a result of a vertebral fracture. The pain may last as long as six weeks while your bones heal. If you suspect that a fracture is possible, see your doctor.

By knowing your risk factors and getting early screenings and diagnosis, you will be taking important steps toward managing your osteoporosis risk, and if necessary, getting early treatment.