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5 Signs Your Osteoporosis May Be Worse Than You Thought

Pay attention to these danger signals and check with your doctor

By Rojeh Melikian, M.D.

Loss of bone density, commonly referred to as osteopenia or osteoporosis, is one of the most common problems of aging. Osteoporosis causes more than 8.9 million broken bones annually, resulting in an osteoporosis-related fracture once every three seconds, according to the International Osteoporosis Foundation.

The amount of bone density we have typically peaks around the age of 30. Following that, most people experience a slow, steady decline in bone density over their lifetime. When your bone density levels drop below a certain level, you are diagnosed with osteoporosis. However, bone density loss occurs along a spectrum, and even those with milder amounts of bone density loss are still at risk for fractures.

Loss of bone density can occur silently with very little in the way of symptoms. Often, the earliest sign of osteoporosis is when a patient breaks a bone after a seemingly benign injury, also known as a fragility fracture.

Danger Signs

Here are 5 red flags you should watch out for:

Developing a stooped posture  This can occur as a result of multiple osteoporotic fractures in your spine, which cause it to lose its normal curvature. As the front portion of your vertebrae collapses, it causes you to hunch forward. This position places additional stress on the surrounding vertebrae and may in and of itself cause another fracture.

Progressive loss of height  As the vertebral bones in your spine weaken and start to collapse, you may notice loss of height as time goes along. Loss of height tends to happen normally as we age due to loss of water content in the discs of our spines, but it occurs more rapidly and due to a different mechanism in patients with osteoporosis.

Sudden back pain without being able to recall an injury  When the vertebrae give way, you may experience pain related to vertebral compression fractures. Most patients brush off the pain for weeks, as they do not recall hurting themselves. However, osteoporotic fractures do not require an injury to occur. It is estimated that only one-third of vertebral fractures come to the attention of physicians.

Having a fracture after a seemingly innocuous incident  If you step off a curb and fracture your ankle, or fracture your spine while climbing stairs, your bone density may have already dropped down to levels too weak to support the weight of your body during certain activities.

Fractured wrists or hips after a fall  In addition to vertebral fractures, broken wrists and hips are the most common types of fragility fractures.

Get Tested


If you have any of these symptoms, it’s time to visit your doctor to discuss a bone density test. The most common way to do this is with a test called Dual X-ray Absorptiometry (DXA or DEXA), which typically measures bone density in your lumbar spine and your hip. Identifying bone density loss, as early in the process as possible, is paramount to obtaining good outcomes.

In general, women over 65, women who have risk factors for osteoporosis (being Caucasian, having a family history of osteoporosis, being slender), and men or women who have had a fragility fracture should be screened for osteoporosis with a bone density test.

No matter what your bone density, it is important to optimize your Vitamin D and calcium intake, as well as undertake a regular regimen of weight-bearing exercise. Getting enough of these three things will help slow the decline in bone density which occurs naturally over time.

If your bone density has already decreased to the point where you are at risk of fracture, your doctor may opt to place you on medications designed to slow the decline in bone mineral density or medications that can act to increase your bone mineral density.

A Surgical Option

If you have already developed a vertebral compression fracture due to osteoporosis, you may be a candidate for a minimally invasive spine procedure called kyphoplasty. (Editor’s note: Scientific research has shown mixed results on the effectiveness of the surgery and, as with any surgery, there are risks.) During this procedure, a small tube is introduced into the collapsed vertebrae under X-ray guidance. Through this tube, a small balloon is placed into your collapsed vertebrae and inflated to restore the fractured vertebrae’s height and shape.

The empty space created by the balloon is then back-filled with a bone cement which hardens in place and helps maintain the height and shape of your vertebrae. The procedure can be done by a spine surgeon in an outpatient setting, with most patients being discharged home the same day.

Bone density loss occurs relatively silently from the age of 30 on. Knowing when to get your bone density checked and what to watch out for will allow you to slow or reverse the process before it’s too late.

Rojeh Melikian, M.D. Dr. Rojeh Melikian of DISC Sports & Spine Center in southern California is a fellowship-trained orthopedic spine surgeon whose background combines rigorous training in reconstructive orthopedic spine surgery with minimally invasive techniques. The author of numerous presentations, posters and journal articles on spine surgery, Melikian has a special focus on cervical and lumbar degenerative spine surgery, lateral-access and anterior surgery (XLIF and ALIF), minimally invasive surgery, spine trauma and spinal tumors. After graduating summa cum laude with a B.S. in Neuroscience from UCLA, Melikian completed medical school at the University of Southern California, where he became a member of the Alpha Omega Alpha Honor Society and graduated with highest distinction. Read More
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