By: Paul Xiong and Igor Klibanov
Generally speaking, everyone knows what osteoporosis is: weak bones. But what happens when you have weak bones? In other words, what are the symptoms of osteoporosis? That’s exactly what we’ll cover in this article.
You’re probably here because you either suspect you have osteoporosis and want to know what the symptoms are, or you’ve recently been diagnosed with osteoporosis and are curious about what the future holds for you.
If you’re part of the latter and haven’t noticed any significant symptoms, there’s a good reason for that (which you will find out later in this article).
So, get ready to learn about:
● What is osteoporosis
● Bone strength progression
● Osteoporosis symptoms in the later stages
● And some indicators of osteoporosis
But first, who am I?
Hi 🙂
My name is Igor, and I’m the author of the Amazon bestselling book, Osteoporosis Reversal Secrets. I’m also a certified personal trainer who specializes in helping clients with osteoporosis improve their bone density, bone strength, and prevent fractures and falls.
I know how scary having osteoporosis can be, so don’t worry as I’ll help you better understand this condition.
Now, without further ado, let’s get into our first topic:
What is Osteoporosis?
Osteoporosis is one of the many musculoskeletal diseases, that occurs when too much bone mass is lost, and the loss of old bone is greater than the creation of new bone.
The condition is characterized by weak bones. They’re thin, brittle, and prone to breaking or fracturing. For better or worse, osteoporosis is known as a “silent disease,” meaning you don’t usually see any symptoms, or know if you do have osteoporosis until you experience a fracture. So, why is this good and bad?
It’s good that osteoporosis has no symptoms so you can go through your normal day without any sort of discomfort or make significant changes. The science behind this is that bones have no sensation, and whether your bones are weak or not (as a result of osteoporosis), you won’t feel much different. Weak bones don’t hurt. Broken bones hurt.
However, the downside is that osteoporosis works the same as any other condition in the sense that you should worry about it. If you have a disease, wouldn’t you want to know all about it? That way, knowing about its symptoms and causes helps understand how to deal with it and prevent it from progressing further. That’s what makes it difficult to tell if you need to worry or take any action, and can also be a very rude awakening when getting that first fracture.
Fortunately, there are precautions or lifestyle changes to increase your bone strength which will lower your chances of osteoporosis and improve your condition for those already diagnosed.
But, before we get into that, let’s talk about bone strength progression.
What is Bone Strength Progression?
Bone strength progression is an important factor in determining how likely you are to develop osteoporosis. Bone strength progression is the speed at which your bones deteriorate and rebuild, and that speed differs in men and women (as well as other factors I’ll get into later).
You might’ve heard how women are more prone to developing osteoporosis and that’s because they have a lower peak bone mass.
Women’s bones get stronger up until about age 20-25 (or 18-22 in east Asian women), then they hold steady until around age 30, and decline slowly after that. The speed of decline becomes even faster leading up to menopause and beyond because of lower estrogen levels.
On the other hand, men’s bones get stronger until about age 25-30, a whole 5-10 years extra compared to women. They also hold steady until around age 45-50 and decline slowly after that. So not only do men have more time to strengthen their bones, but they also stay stronger for a longer time than women.
Besides the difference in peak bone mass, another reason why women are more prone is simply because they live longer than men. Women have a higher life expectancy by an average of 4-6 years, which gives them a higher risk of developing osteoporosis.
Gender is not the only risk factor for bone strength. Your bone mass can decline at different rates, either slowly or quickly, and the speed of decline is determined heavily by:
● Diet: are you eating adequate protein?
● Exercise: are you doing both strength training and some kind of impact-based activity? ● Hormonal profile: what are your estrogen and testosterone levels like?
● Vitamin D status: are you getting enough vitamin D? Or, do you have excessive vitamin D levels, which can also result in osteoporosis.
So let’s go over each factor in order.
Factors Influencing Bone Strength
When it comes to your diet, many people think that calcium is the most important nutrient, but contrary to popular belief, it’s not. That’s been disproven many times like this study and this one. How calcium actually works is that it increases bone density but does not reduce fracture risk. Think of it like cheating on a test. You might’ve got a higher score, but do you really have a good understanding? Consuming calcium is like “cheating” your way to a higher score on a test of bone health, and it will not decrease your risk of bone fractures.
So if calcium is largely irrelevant, what is the most important nutrient for bone strength? Protein! Protein makes up approximately 50% of bone volume and one-third of bone mass, and without enough protein, it would be difficult to build up your bone density. So consuming an adequate amount of protein is the best thing you can do for osteoporosis on the nutritional side of things. How much is adequate? That depends on your age (people over 60 need more than those under 60), your body weight, and your activity levels. While figuring out optimal protein intake is beyond the scope of this article, you can read about it here.
Next is exercise. The most effective exercises for bone strength are any kind of jumping exercise or strength training. So while activities like walking, cycling, swimming, hiking, and cardio are good for many reasons (like cardiovascular health, immune health, mental health, etc.), they don’t have enough impact or resistance to strengthen your bones. Only strength training and jump training improves bone strength. Those are weight-bearing exercises that improve bone strength. There are also lots of weight-bearing exercises (like walking, jogging, etc.) that don’t improve bone strength.
Another factor is certain hormones. The big hormonal event that happens in women’s lives is menopause. And when menopause starts, estrogen drops. However, the speed of estrogen decline is different in different women. And not just the speed, but the extent too. Women who have an extra large drop in estrogen will experience a greater loss in bone density compared to a woman with a smaller drop of estrogen. Same with testosterone for both men and women. The lower your hormone levels are, the more likely you are to develop osteoporosis.
And the final factor is your vitamin D status. If your vitamin D levels are low, bringing them up to adequate will have a very nice improvement to low bone density. Conversely, having too much vitamin D will not improve it even more. With most nutrients, to go from deficiency to sufficiency will be very beneficial and healthy. To go from sufficiency to excess is somewhere between useless and harmful. Some ways to get vitamin D are through natural sunlight, certain foods like egg yolk or fortified foods, and supplements.
These are the main 4 factors that determine the speed of decline, and if optimized, a person may never get osteoporosis. Osteoporosis is very much preventable. And these factors are not super difficult or time-consuming, so consider incorporating them into your lifestyle. If you’re thinking it would be too difficult, consider getting a personal trainer to work with you on the proper exercise and nutrition program.
If you want to know all about the causes of osteoporosis and more on how you can incorporate these (and more), check out my other article, What is the Cause of Osteoporosis.
Now moving on to the next topic, I know I said there aren’t any symptoms for osteoporosis in the early stages, but that isn’t exactly true during the later stages.
Symptoms of Osteoporosis after Progression
The symptoms of osteoporosis only appear in the later stages because the condition involves a gradual loss of bone mineral density over time. This process can take many years or even decades before enough bone has been lost to cause noticeable symptoms or a fracture.
Your bones can become weak enough that even a little bit of impact, like a small bump, can fracture them. Let me give you an example. Imagine you’re walking to the washroom late at night, it’s completely dark, and you can’t see where you’re going. As you’re walking down your hallway, you accidentally stub your toe. The average person may feel a little pain (and maybe swear a lot), but people with osteoporosis may break their toes (and still swear a lot).
Minor impacts like this may appear insignificant, but it doesn’t take much force to break fragile bones. And that’s not all. In more severe conditions with very weak bones, even coughing, sneezing, or just standing can fracture bones.
Some more symptoms you can start to see after developing osteoporosis are:
● Fractures. Osteoporotic fractures can occur in any bone, but the most common are wrist fractures, spinal fractures, and hip fractures. These fractures may occur with minimal or no trauma, such as bumping into your kitchen counter.
● Compression fractures. The vertebrae in your lower back become unable to support the body mass above them, resulting in a fracture and severe back pain.
● Loss of height. As the bones in the spine become more brittle and prone to fractures, they may start to collapse, leading to a loss of height.
● Stooped or hunched posture (otherwise known as kyphosis or Dowager’s hump)
● Lower back or neck pain due to fractured vertebrae. Osteoporosis can cause the bones in the spine to become fragile and prone to fractures, leading to severe pain.
● Shortness of breath because of poor posture (which decreases lung capacity)
I know it’s scary that little gestures like coughing or sneezing can break a bone. Osteoporosis is not a good thing to have, so what if I told you that there are also some ways to predict it?
Predicting Osteoporosis
Despite how osteoporosis shows no symptoms, there are a few signs that can help you predict if you have osteoporosis.
But, before I mention these indicators, I would like to emphasize that they are not necessarily direct indicators of osteoporosis but may be related to bone health in some way.
So, these signs/tests are:
● The squat test
● Poor grip strength
● Fingernails chip, peel or break easily
● A decline in general fitness (poor strength and endurance)
As a personal trainer, one simple, low-tech test for osteoporosis that I use with my clients is the squat test. I will ask my clients to squat all the way down and then back up and observe how much effort they put in. If they’re coming back up and really grinding it out, they are so weak that it puts them at a high risk of osteoporosis. If they can go down and pop straight back up, then their bones are strong enough. Simple, right? But make sure when you test, you squat all the way down, with your butt to your heels for accurate results.
Another test is grip strength, which is the amount of force you can exert with your hand, fingers, and forearm to hold or pull onto objects. A low-tech way to measure poor grip strength is whether you can open jar lids or hang on to groceries over a certain weight. A more high-tech way to measure grip strength is to buy a device called a grip strength dynamometer. This device allows you to grip a handle and displays how many pounds of force you are putting in.
Your fingernail condition can also predict if you are at greater risk for osteoporosis. We know the most important nutrient for osteoporosis is protein. Your fingernails are a good indication if you’re getting adequate or inadequate protein. Brittle or thin fingernails can be a sign of inadequate protein.
The last possible predictor is a decline in general fitness. This means poor strength and endurance. Think to yourself, are you finding yourself becoming weaker and weaker, unable to do things you were able to easily do before? Is holding groceries more difficult than it used to be, without an increase in the weight of the groceries?
The more of these factors you have, the more likely you are to have osteoporosis and suffer a fracture. If you are experiencing any of these predictors or are concerned about your risk of osteoporosis, it is important to speak with your healthcare provider. They can also perform a bone density test to assess your bone health or bone loss and recommend treatment options if necessary.
Symptoms of Osteoporosis – The Bottom Line
Now, let’s sum up everything we’ve learned. Osteoporosis is known as a silent disease because there are typically no symptoms… until you break a bone. Because of this, it’s difficult to identify whether you do have osteoporosis, however, your fingernails and grip strength are a couple of signs that can give you a heads up that you are at risk.
Also, there are a few factors that can help prevent osteoporosis or improve your condition. These are: eating enough protein, doing strength training or jump training (or both), maintaining normal estrogen and testosterone levels for your age, and having adequate vitamin D levels (remember not too much or too little).
And again, read What is the Cause of Osteoporosis to find out foods are high in protein, the proper exercises for strengthening bones, how to get adequate vitamin D levels, and more.
It’s important to understand that osteoporosis is very much preventable and manageable, and taking the right steps to maintain a healthy lifestyle and healthy bones.
You also want to make sure to work closely with your doctor or a personal trainer to develop an osteoporosis plan that’s right for you, and keep them updated on any changes in your condition or health status.
If you would like some personalized help with your osteoporosis, just fill out the application form on our home page.
