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Most people discover they have osteoporosis only after they suffer a debilitating broken bone or a painful fracture. There are at least 10 symptoms and signs of osteoporosis, however, that serve as red warning flags that osteoporosis is possible.

Most people learn they have osteoporosis through a painful, unexpected event. Maybe they reach down to pet the cat and their leg bends at the knee and rolls out at the ankle while they feel unbearable pain in the hip. Or maybe a cough breaks a rib. Or serving a ping pong ball breaks a wrist.

Fragility fractures are a strong sign that osteoporosis has already caused damage to bone. But there are subtle symptoms and signs that osteoporosis is a fracture waiting to happen if you are only aware of its possibility. Here are 10.

1. You're shorter than you used to be

The author of this article has osteoporosis. At the age of 20, he was 5'11-3/4" (182.2 cm) tall. At the age of 50, he was 5'10" (178 cm) tall. Microscopic fractures in the vertebrae may accumulate so that both men and women lose height as the get older. The effect is usually more pronounced in women, who may even develop a dowager's hump that bows the back upward and the face down. But both men and women can lose bone minerals as they age if they are not aware of that they need to be taking care of osteoporosis.

2. You tend to lean toward one side

For months, Alicia felt like she was falling to her right side. When she got up from a chair, she would start to slide to the right. When she went skating, she had to catch herself from falling to her right. Eventually, one day she tried to get off the sofa and her right hip gave her a searing pain. Alicia had an osteoporotic fracture of her hip. It was the simple act of getting off a soft sofa that eventually caused that last fracture that resulted in real pain. But for months she had warning signs that somehow muscles weren't sliding over her femur smoothly. She just didn't know that the likely cause was osteoporosis.

3. You don't have the grip strength you used to

Do you have to get your wife to help you open the pickle jar? Do your fingers get crossed when you try to open a plastic bag? Do you faint at the idea of having to loosen a lug nut to change a tire? If you don't have the grip strength you used to, the underlying problem could be osteoporosis. Oddly enough, poor grip strength in women who have passed menopause is correlated with osteoporosis of the hip. The inability to "get a grip" may be a warning sign that a hip fracture is in your future.

4. Weak and brittle fingernails predict weak and brittle bones

There is a lot of anecdotal evidence that weak fingernails predict weak bones. To be strictly accurate, however, a study of keratin in women's fingernails failed to find differences between the nails of women who had osteoporosis and women who did not. It is possible, however, that the scientists were looking at the wrong protein. Keratin, after all, is not a component of bone.

5. People who are "long in the tooth" tend to have brittle bones

Receding gums are considered an indicator of poor bone health. Lithuanian researchers have established a definite connection between gum health and health of the jawbone. The common factor is a deficiency of vitamin D. So if you have receding gums, you may need to start taking 1000 to 2000 IU of vitamin D every day, both for your gums and for your bones.

6. Cramps and muscle aches are often a sign of bone problems

Both bones and muscles need magnesium. If you are deficient in magnesium, you may get muscle cramps, and you probably won't have healthy bones. But sometimes cramps are more than a sign of mineral deficiency. If you already have microfractures in your hip, it would not be unusual for you to experience cramping of the muscles across the front of your leg that is relieved by bending your leg at the knee, shortening your leg, or rolling your leg outward. If this is your experience, take 200 to 600 mg of magnesium supplements daily, but ask your doctor if DXA scanning might be a good idea.

7. Your bones hurt all the time

As we get older, some of us become "human barometers". When there is a change in weather coming, we feel it in our bones. Usually this sensation is attributed to arthritis. However, if this "achy bones, breaky bones" sensation occurs in the neck, lower back, wrist, or hip, it may be a good idea to get checked out for osteoporosis.

The bone pain associated with osteoporosis follows a predictable pattern:

  • There is a definite location of the pain. You don't "ache all over". You have bone pain at a specific joint or a specific location.
  • There was a minor trauma just before the onset of the pain. Maybe you were picking up a suitcase. Maybe you slipped and fell. But when osteoporosis causes pain, there is usually a minor triggering event. (A major trauma, of course, can also damage bone.)
  • The pain may be sharp, nagging, or dull, but chances are it does not just go away.
  • Movement makes pain worse. Staying still relieves it.
  • For compression fractures of the spine, there may be muscle spasms at the same level as the pain.
  • Sometimes back pain radiates to the abdomen. There may also be constipation, hiccups, or burping.
  • Lying still "just so," motionless, sometimes relieves pain.
  • Pain of fractures tends to resolve on its own after four to six weeks, but the pain of multiple untreated fractures becomes permenent.

  • Li YZ, Zhuang HF, Cai SQ, Lin CK, Wang PW, Yan LS, Lin JK, Yu HM. Low Grip Strength is a Strong Risk Factor of Osteoporosis in Postmenopausal Women. Orthop Surg. 2018 Feb. 10(1):17-22. doi: 10.1111/os.12360. Epub 2018 Feb 12.
  • Jagelavičienė E, Vaitkevičienė I, Šilingaitė D, Šinkūnaitė E, Daugėlaitė G. The Relationship between Vitamin D and Periodontal Pathology. Medicina (Kaunas). 2018 Jun 12. 54(3). pii: E45. doi: 10.3390/medicina54030045.\
  • Mussatto JC, Perez MC, de Souza RA, Pacheco MT, Zângaro RA, Silveira L Jr. Could the bone mineral density (T-score) be correlated with the Raman spectral features of keratin from women's nails and be used to predict osteoporosis? Lasers Med Sci. 2015 Jan. 30(1):287-94. doi: 10.1007/s10103-014-1647-8. Epub 2014 Sep 21.
  • Photo courtesy of SteadyHealth

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