Osteoporosis: Symptoms, Risk factors and Diagnosis

Osteoporosis is a bone disease that causes our bones to become weak and more likely to a fracture in a longer duration of time. It is also known as a “silent disease” because the bones become brittle without any symptoms. Fractures can happen in any bone, but osteoporosis-related fractures mostly occur in the spine, hip, and wrist. A bone is a living tissue that keeps on changing through a process called remodeling – older bones making way to build new bones. When people reach their 40s, the peak of their bone density slowly starts to decrease. At this age in life, it becomes crucial to know the importance of bone health.




During the early stages of bone loss, there are typically no symptoms. The first symptom of osteoporosis is the fracture or breaking of bone because of a minor fall. Some of the other symptoms include: 


  • Stress fractures (or tiny cracks in a bone) that feel like joint or muscle pain
  • Gradual height loss
  • Back pain
  • Shortness of breath (due to compressed disks)
  • Change in posture


Risk factors


Certain factors raises your risk of getting osteoporosis:


Age - With age, our bones naturally become thinner and this increases the risk of getting osteoporosis

Your sex - Being a woman raises your risk of developing osteoporosis

Race - Caucasian and Asian women are at a higher risk

Body weight - Thin people are at higher risk of developing osteoporosis

Family history - If one of your parents has had a broken bone, especially a broken hip, you are at greater risk of developing osteoporosis

Excessive alcohol consumption and smoking

Dietary factors - It is more likely in people with low calcium and vitamin D intake

Steroids and other medications - Oral or injected corticosteroid medications may hinder the bone-rebuilding process

Medical conditions - Celiac disease, inflammatory bowel disease, kidney or liver diseases, cancer, and rheumatoid arthritis, can raise the risk of developing the disease

Sedentary lifestyle - People who spend a lot of time sitting at a desk are more prone to osteoporosis




Pain - The disease weakens the bones which results in hunched posture, loss of height, and back pain

Limited mobility - Fractures can cause limited mobility or the inability to stand up for a long period. Being physically inactive can cause you to gain weight and increase the stress on bones

Nursing home care - People who have a hip fracture may require long-term nursing care. A bed-ridden person is more likely to experience cardiovascular complications and increased susceptibility to infectious diseases.


Diagnosis of osteoporosis


If your doctor suspects a case of osteoporosis, you may be required to take a bone mineral density (BMD) test.




BMD tests are also called dual-energy X-ray absorptiometry (DEXA or DXA). The amount of radiation used in these scans is very small as it helps find out how solid the bones of the hip, wrist, and spine are. DEXA is a simple, quick, and non-invasive test, that is usually performed on the lower spine and hips. The scan helps evaluate the risk of osteoporosis fractures and monitor a person’s response to treatment. 


The results of a DEXA scan is measured in form of T scores or Z scores. While the T scores compare bone density with that of a healthy 30-year-old of the same sex, the Z scores compare bone density to a similar population as the patient in terms of age, size, and sex. 


Blood tests

A blood test can help find out: 

Vitamin D deficiency

Calcium levels or deficiency

Hormone levels


Medical conditions including parathyroid and thyroid malfunctioning can cause bone loss. Testing for thyroid function and testosterone levels in men can help find out the cause of osteoporosis. 


Other tests

Your doctor can also order an ultrasound scan of the heel bone to assess osteoporosis.



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