Three warning signs that you may have osteoporosis

man with back pain
Osteoporosis can creep up on you without any visible symptoms – but sometimes there are ‘red flags’ that should prompt you to ask for testing.

Osteoporosis is often called the ‘silent disease’ because bone loss occurs gradually without any signs or symptoms. Eventually the skeleton becomes so weak and fragile that even a minor fall from standing height, a bump, or a sudden movement can result in a broken bone.

‘Invisible’ though it may be, there are three potential tell-tale signs of osteoporosis which should prompt you to seek testing and advice from your doctor, particularly if you’re aged 50 and over.

1. Developing a stooped posture or progressive loss of height

A stooped back can occur as a result of multiple osteoporotic fractures in your spine, which cause it to lose its normal curvature. As the vertebrae in your spine collapse (i.e. vertebral fractures), your back begins to hunch forward. This can develop gradually without being noticed. As the vertebral bones in your spine weaken and start to collapse, there may be loss of height, even without a noticeable stooped back. Some loss of height occurs naturally as we age, but it happens more rapidly and due to a different mechanism in patients with osteoporosis. If you’ve lost more than 3 cm in height (just over 1 inch), it’s a sign that something may be wrong.
Under-diagnosis of vertebral fractures is a worldwide problem, with only one-third of these fractures coming to the attention of physicians. It’s a concern because one vertebral fracture often leads to more fractures – and patients may end up with a series of debilitating fractures if left untreated.

2. Sudden back pain without any obvious cause

In people with osteoporosis, a vertebral fracture can occur spontaneously or as a result of something as trivial as bending over to tie a shoelace. Any adult who experiences sudden or very intense back pain for no discernable reason should investigate further – it is a potential warning sign of vertebral fractures due to osteoporosis. The pain may be so severe that the patient is immobile, or it may be less severe. In the latter case, patients may then put off going to the doctor and simply wait for the back pain to subside. Unfortunately, many patients with osteoporosis have reported that their doctors simply gave them pain killers without exploring osteoporosis as a possible underlying cause. If you’ve had unexplained back pain you should ask your doctor for a thorough examination that includes a bone health assessment.

3. Having a fracture after a seemingly minor incident

If you’re over age 50 and you suffer a fracture after something as simple as a slip on the pavement or a sudden movement, it is a sign that you have weak bones and need assessment and most likely treatment for osteoporosis. Whether a vertebral (spine) compression fracture, a broken wrist or a broken hip, any unexplained fracture or one caused by a low-trauma incident (such as a fall from standing height or less) should not be ignored!  Be sure to ‘make your first break your last’ by asking for testing, and staying on your osteoporosis treatment if it has been prescribed.

Be on the alert

In addition to these three ‘red flags’, there are other factors that might indicate an increased risk of osteoporosis and need for assessment. Complete the IOF One-Minute Osteoporosis Risk Test to see whether you have any recognized risk factors. When you discuss osteoporosis with your doctor, enquire about FRAX (WHO Fracture Risk Assessment Tool) that can be simply completed online. The FRAX calculator will determine your 10-year risk of having an osteoporotic fracture, based on your risk factors with, or without, bone mineral density (BMD) values.

Being on the alert for risk factors and getting early assessment and treatment if needed is the first step to a mobile, active future – free of fragility fractures, related disability and loss of quality of life.