Symptoms of Osteoporosis

Osteoporosis is a "silent" disease. Insufficient bone mass and bone loss are generally not accompanied by noticeable physical symptoms, which makes routine screening for bone strength in high-risk groups of people (such as elderly women) especially important. The only major symptoms of osteoporosis are bone fracture or vertebral collapse, and most people do not know they have the disorder until they experience their first fracture. Severe back pain, difficulty standing up straight, kyphosis, and loss of height are indications of possible osteoporosis.

Our bones are constantly remodeled throughout life. They are digested by cells called osteoclasts and then built back up by other cells called osteoblasts. This remodeling process is important for healing microscopic fractures that occur during daily activities. Unfortunately the activity of osteoblasts slows down as we age while osteoclasts keep eating away at bone at a fairly steady rate. Over time, this results in low bone density. Also, bone density loss increases when circulating female hormones decrease after menopause. More on the pathogenesis of osteoporosis.

As bone loss increases with age, the steady process of remodeling, or bone turnover removes bone more than it replaces it. It involves 2 distinct stages, namely bone resorption or bone formation, and bone formation. Since calcium is stored in the bones, cells known as osteoclasts surface and attach to the bone surface when there is a need for calcium. Osteoblasts, bone-forming cells, then break the bone down and leave tiny cavities and infiltrate them with collagen and other proteins to stimulate bone mineralization. After osteoblasts merge with calcium and other proteins and minerals, a new matrix of bone material replaces what was lost, making them osteocytes.

According to Harvard Women's Health Watch, resorption at a particular bone site takes approximately two weeks, whereas formation could take 3 months or more. If the remodeling process is out of balance, bone turnover can result in major bone loss, so in this way bone turnover is congruent to fracture risk.

As men and women approach age 35, bone breakdown supersedes bone build up and advances low bone density to an almost default position for many nearing middle-aged adults. For several years, women lose bone two to four times faster than they did before menopause, according to FDA Consumer Magazine. "Bone remodeling" according to the Cleveland Clinic, is the process of rebuilding the body's bone or calcium supply slows down and inevitably takes more of a toll, depending on the state of one's overall health.

Doctors might suspect when a patient has disorders or treatments known to cause osteoporosis such as hypogonadism, hyperparathyroidism, hypercalciuria, and glucocorticoid therapy.

A widespread procedure used for diagnosing osteoporosis is the dual-energy x-ray absorptiometry (DEXA) test.

Hip Fractures

A study of trends found that hip fractures among Americans increase from the mid-80s to the mid-90s and then declined to the mid 2000s. The mortality rate from hip fractures also decreased during the same period.

Osteopenia

The often under-recognized condition of osteopenia can be a precursor to the development of osteoporosis is treatable. Patients and doctors should keep their eyes out for osteopenia and make an informed decision as to the need to take medication alongside exercise therapy, dietary and lifestyle modifications. More on osteopenia.

Other bone diseases that can be confused with osteoporosis include osteomalacia (rickets) and osteonecrosis.