Fri, 31 March 2023
The Daily Ittefaq

Osteoporosis: A silent killer

Update : 24 May 2022, 14:23

Osteoporosis is a disease in which one’s bones deteriorate, becoming thin and brittle and increasing the potential for fracture. The disease has been called the “silent killer” because early stages of the disease are difficult to detect and diagnose.

Those with osteoporosis often receive a definitive diagnosis only after suffering one or multiple tell-tale bone fractures. Other diagnoses may come after the disease has had a significant effect on a person’s quality of life or has led to irreversible damage and disability. Fractures most commonly occur in the spine, hip, and wrist. Among these, hip fractures are usually the most serious and can lead to repeated fractures, permanent disability or even death.

Although osteoporosis is more common in older adults, it can affect people of all ages. Another risk factor for the disease is gender, with an estimated 1 in 2 women over age 50 and 1 in 4 men over age 50 likely to break a bone from osteoporosis. Additionally, menopause, family history, race, low body weight, poor intake of calcium and vitamin D, poor dietary habits, inactivity, smoking, excessive alcohol intake, certain medicines and other medical conditions can all affect a client’s risk for developing osteoporosis. 

Discover some of the common signs and symptoms

Osteoporosis is considered a “silent disease” because it often does not display symptoms until a bone fracture occurs. However, in later stages of the disease, symptoms may include back pain, loss of height over time, a hunched posture and frequent broken bones. These fractures can occur from normal stresses – such as bending, lifting or even sneezing – which healthy bones would easily tolerate. 

Brittle fingernails

The most common reasons for brittle fingernails are hormonal changes and nutrition. Women who are going through menopause have fluctuating estrogen levels. On top of causing dry skin and thinning hair, this can also affect nail strength and may be a sign of early bone loss.

Brittle nails can also be a sign of a nutritional deficiency, like vitamin C, calcium, or folic acid. That’s why it’s important to maintain a balanced diet rich in these nutrients as well as protein and healthy fats.

Receding gums

Bone loss is directly related to oral and dental health. After all, 99% of the calcium in your body is in your bones and teeth!

Research suggests bone loss in your jaw and mouth can be a sign of bone loss in other areas of your body. If your jaw bone is deteriorating, your gums will follow suit and begin to recede. So next time you give your pearly whites a scrub, take a moment to look around and notice any changes to your gumline.

Weak grip strength

Manufacturers are notorious for over-tightening jam jar lids. Yes, those vats of bulk-buy pasta sauce are a great deal, but if you’ve noticed those jars getting heavier and harder to open, the real cause could actually be your bones.Those with low grip strength has correspondingly low bone mineral density measurements in the spine and hip. Risk of vertebral fracture also increased as grip strength decreased.

Decrease in overall fitness

Another early indicator of osteoporosis is an overall decline in physical fitness. Some things to look out for are decreased muscle strength, poor balance, and decreased aerobic abilities. So if you’ve been finding it increasingly difficult to walk, dance, or just do everyday activities, this is important:

No matter your age or current level of health, a little exercise can go a long way towards improving muscle strength. Resistance and strength training exercises are great ways to improve muscle mass. Or try walking, jogging, hiking, pilates, tennis, and dancing to help improve bone health.
Loss of height

Ever get the feeling that you’re shrinking? Well, you might be! And there’s a chance it’s not just age-related.

While it’s normal to lose a little height as you age, too much height loss can be a warning sign of a vertebral fracture. In fact, it is not uncommon for someone to report back pain, only to discover it’s actually a fractured vertebra in their spine.

In addition to loss of height, typical signs of a spinal fracture from osteoporosis include a sudden onset of back pain, limited mobility in the spine, and increased pain or discomfort when standing or walking. However, sometimes a vertebral compression fracture may not cause any pain or other obvious symptoms, according to Spine Health. That’s why it’s so important to regularly consult with a physician, especially if you know or suspect you have osteoporosis.

Another giveaway that your bone health is compromised is kyphosis. Kyphosis is often known as a curved spine or sometimes a Dowager’s Hump, and can be caused by multiple spine fractures. The bones of the vertebrae become so weak they crumble like weathered bricks.

Cramping and aching muscle or bone pain

Start listening to what your body is trying to tell you, especially if those achy bones come with a side of sore, cramping muscles.

For instance, vitamin D deficiency has been linked with back pain. Further, magnesium deficiency has been linked to osteoporosis, muscle weakness, and cramps.

Stooped posture or compression fracture

One of the most common causes of osteoporosis pain is a spinal compression fracture, and one of the most common symptoms is a curved spine. Spinal compression fractures cause sudden, severe back pain that worsens when you are standing or walking. Bending and twisting will also make it worse, but laying down can provide some relief.

Treatment and management 

There are a variety of treatment options for a patient diagnosed with osteoporosis or low bone mass. 


The benefits of taking a drug are clearly far greater than the possible risks

There are several medication options available for the treatment of osteoporosis, including hormone therapy, bisphosphonates, biologics and anabolic agents.  

Calcium-rich diet

If there is not enough calcium in the blood, your body will take calcium from your bones

An adequate intake of calcium is a vital step to building and maintaining strong, healthy bones. If there is not enough calcium in the blood, your body will take calcium from your bones. Dairy foods – like milk, cheese and yogurt – are great sources of calcium. In fact, 1 cup of milk contains about 300 milligrams of calcium. Calcium can also be found in green vegetables such as broccoli, brussels sprouts and kale, as well as in canned fish such as sardines and salmon, and other fortified foods. Vitamin D helps the body absorb calcium. The best way to get vitamin D is from sunlight or supplements, but vitamin D is also found in fatty fish and fortified foods, like milk, orange juice and cereal.  

Vitamin D

Vitamin D promote bone density. Vitamin D is important because it helps your body absorb the calcium in your diet. We obtain most of our vitamin D from the sun, and there are recommendations for the amount of safe sun exposure for sufficient vitamin D production, depending on your skin type, geographical location in Australia and the season. 

We obtain most of our vitamin D from the sun

Vitamin D can also be found in small quantities in foods such as: fatty fish (salmon, herring, mackerel), liver, eggs, fortified foods such as low-fat milks and margarine. For most people, it is unlikely that adequate quantities of vitamin D will be obtained through diet alone. Talk with your health professional about vitamin D supplements if you are concerned that you are not getting enough vitamin D.

Balanced diet

A balanced diet with adequate protein and reduced sodium can help protect your bones

Research has shown that diets including a variety of fruits, vegetables, whole grains, dairy foods, nuts and legumes are associated with greater bone mineral density and lower risk for fracture compared to a diet of processed meats, soft drinks, fried foods, desserts and refined grains. Overall, a balanced diet with adequate protein and reduced sodium can help protect your bones.   


Exercise can improve balance, decrease the risk of bone fractures and relieve or decrease pain

Physical activity is not only important for building strong muscles, but also in maintaining bone mass. It can improve balance, decrease the risk of bone fractures, maintain or improve posture, and relieve or decrease pain. There are two types of exercises that are significant in maintaining bone density: weight-bearing exercises (walking, elliptical training and dancing) and strengthening exercises (weightlifting, using elastic bands and body weight exercises).  

Lifestyle change

Lifestyle changes play an important part of managing osteoporosis

General recommendations for lifestyle changes may include: 

Stop smoking – smokers have lower bone density than non-smokers
Get some sun – exposure of some skin to the sun needs to occur on most days of the week to allow enough vitamin D production.
Limit caffeinated drinks – excessive caffeine can affect the amount of calcium that our body absorbs. Drink no more than two to three cups per day of cola, tea or coffee.

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More on this topic