Symptoms of a Silent Disease
Osteoporosis isn’t like most diseases. There are usually no tell-tale symptoms that alert you to its presence early on in its progression. Even if your bones are becoming weaker, you likely won’t feel it. That’s why osteoporosis is sometimes called “the silent disease.”
For most people, the first indication that they have osteoporosis is a fracture. These fractures may cause a loss of height, and you may notice your spine starting to hunch forward. Neck or low back pain caused by a fractured or collapsed vertebra can be another symptom as well as a fracture elsewhere in the body that occurs with no memory of trauma to the area. Dental x-rays that show the loss of bone in the jaw can also be a sign of osteoporosis. The problem is, when fractures occur, osteoporosis is already in an advanced stage.
As we age, the risk for fractures increases. These fractures, which often occur in the wrists, hips, and spine (spinal fractures are known as vertebral compression fractures), are painful and may impact your ability to walk and balance properly. This increases your chances of falling, which is a major cause of further fractures. It is estimated that 1 out of 2 women will suffer from an osteoporotic fracture in their lifetime. For reasons not known, race and gender are risk factors for osteoporosis. Caucasian and Asian women—particularly post menopausal women—are at the highest risk of developing the disease. African American and Hispanic females overall have better bone density than other ethnic groups. These differences can be seen during childhood and adolescence. Men can also be affected but at much lower rates than women.
The interior of the bone—the tissue—contains small holes within it. But a bone with osteoporosis has much larger holes. (Porosis actually means porous.) Bones are living, porous structures that are constantly being broken down and replaced. During childhood and adolescence, much more bone is deposited than withdrawn enabling the body's bones (skeleton) to grow in size and density. The amount of bone tissue is known as bone mass. Ninety percent of peak bone mass is acquired by the age of 18 in girls and the age of 20 in boys. After that the body continues to accumulate bone tissue but at a much slower rate.
Peak bone mass is acheived when the bones have reached their maximum strength and density. The process is completed around the age of 30. When bone tissue is lost faster than the body can replace it, osteoporosis sets in. For women, the initial 5 to 7 years following menopause is a period of rapid bone loss and a leading factor in the development of the disease. In fact, women can lose up to 20% of their bone density during this time.
Proper diagnosis and early treatment is essential to prevent fractures which can seriously limit mobility and independence. More importantly, prevention needs to be started earlier in life. Simple lifestyle changes such as a healthy diet and regular exercise can make a difference down the line. Calcium is necessary to build strong bones so a calcium-rich diet rich throughout life is essential. Dairy foods are a good source of calcium as well as some dark green vegetables like kale, collard greens, broccoli and spinach.
When your diet lacks calcium and your body requires it for normal functioning (calcium is also involved in blood clotting and cell signaling), the nutrient is removed from its storage place in the bones. Over time, this results in weaker, more porous bones. Regular, weight-bearing exercise can also be beneficial as bones are strengthened by walking, jogging, tennis, weight training and other activies that force the body to work against gravity.
Although you may not experience any obvious symptoms, talk to your doctor if you believe you’re at risk for osteoporosis. Aside from gender and race, other risk factors include early menopause (estrogen has bone protecting benefits), a history of corticosteroid use for several months at a time or having parents who suffered hip fractures since genetics plays a role. Finally, avoiding alcohol and cigarette smoking is a good idea since both habits negatively impact bone health.
- Detecting Osteoporosis: The Importance of Testing. In the National Osteoporosis Foundation’s Boning Up on Osteoporosis, Second Edition. 2008: 32.
- Mayo Clinic Osteoporosis Symptoms page. Mayo Clinic Health Information Web site. Available at: http://www.mayoclinic.com/health/hip-fracture/DS00185/DSECTION=symptoms. Accessed April 27, 2009.