Medical Author: William C. Shiel Jr., MD, FACP, FACR
Osteoporosis most often causes no symptoms. The main symptom that osteoporosis can cause is pain as a result of a bone fracture. Other symptoms that osteoporosis can cause are loss of height, hunched posture, and a hump in the upper back (dowager's hump), each as a direct result of compression fracture of vertebrae in the spine.
Interestingly, sometimes osteoporosis leads to bone fracture that causes no symptoms at all. Frequently, these are stress fractures in the elderly. When osteoporosis causes fracture of the spine, aside from long-term deformity, it can result in "band-like" pain on both sides of the body (typically back pain in the middle back or lower back) at the level of the spinal vertebrae that is broken. Fracture of bone away from the spine causes pain and tenderness in the corresponding area of the fracture (wrist, foot, ankle, hip, etc.). There can also be swelling, redness, and bruising in the area.
Signs of osteoporosis include evidence of bone thinning by X-ray testing, CT scan, or MRI. Osteoporosis can then be confirmed by bone density testing (DEXA bone mineral density scan). Of note, osteoporosis can be present for years before any fracture occurs, which is precisely why bone density screening can be used to diagnose occult osteoporosis so that treatment can be initiated to prevent fractures.
Osteoporosis causes and risk factors
Osteoporosis is most often caused by aging. However, osteoporosis can be caused by vitamin D deficiency, hyperparathyroidism, hyperthyroidism, corticosteroid medications (steroids such as prednisone and prednisolone), post-menopause low estrogen state, low testosterone blood levels, alcoholism, smoking, thin body frame, immobility, and malabsorption. It can run in families as an inherited trait.
Gehlbach, S.H., R.T. Burge, E. Puleo, J. Klar. Osteoporosis International 14.1 Jan. 2003: 53-60.
Harris, W.H., and R.P. Heaney. New England Journal of Medicine 280.6 Feb. 6, 1969: 303-11.
Main Article on Osteoporosis Symptoms and Signs
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Examples of Medications for Osteoporosis Symptoms and Signs
- alendronate, Fosamax, Binosto
- Boniva (ibandronate)
- calcium supplements - oral
- estrogens conjugated, Premarin
- Evista (raloxifene)
- Forteo (teriparatide)
- Reclast (zoledronic acid)
- risedronate (Actonel, Actonel with Calcium, Atelvia)
- vitamin D (Drisdol (Vitamin D2), Ergocalciferol (Vitamin D2), Cholecalciferol (Vitamin D3)
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