Osteoporosis May be “Silent” Until a Spinal Fracture Occurs

Osteoporosis is a progressive bone disease that affects men and women (rarely children). It is a disease characterized by low bone mineral density, decreased bone mass, or deterioration of bone tissue. Bones become porous, thin, brittle, and more susceptible to fracture. Although it is highly preventable, and often manageable, some patients may not know they have osteoporosis until they break a bone. In the spine, the types of fractures related to osteoporosis include vertebral compression fracture and burst fracture.

According to the National Osteoporosis Foundation (NOF), 52 million Americans have low bone density or osteoporosis, and this number is projected to increase. NOF facts indicate 1 in 2 women and up to 1 in 4 men over the age of 50 will break a bone because of osteoporosis.

Potential “Early Stage” Symptoms

A few of the symptoms listed below can be caused by many other diseases or disorders. That is one reason to see a neurosurgeon; to confirm the cause of pain or change in the spine’s appearance. ScreenShot003An early diagnosis can help spare a patient from a painful spinal fracture.

  • Lower back or neck pain
  • Bone pain or tenderness;
  • Curved upper back or stooped posture
  • Gradual loss of height
  • Fractures from minor trauma

Causes and Contributing Factors, Risks

Bone loss in women accelerates when estrogen production slows down; usually between the ages of 45 to 55. In men, it’s the decline of testosterone that contributes to bone loss starting around age 45. Like aging, some osteoporosis risk factors cannot be controlled. However, many risk factors are controllable.

  • Eating habits and nutrition: Bone density depends on minerals (eg, calcium) and other nutrients to maintain and build bone strength. Eating disorders, such as anorexia nervosa or extreme dieting can contribute to bone loss. Phosphoric acid, an ingredient in cola beverages can interfere with bones’ ability to absorb calcium.
  • Weight-bearing exercise: A sedentary lifestyle increases the risk of developing osteoporosis. Weight-bearing exercises work the muscles and bones against gravity. Examples of weight-bearing exercise include, walking, jogging, and weight lifting.

Suggestion:Before starting a weight-bearing exercise program, a patient should speak with their treating physician or neurosurgeon; especially if the patient has been diagnosed with osteopenia, osteoporosis, or does not exercise regularly.

  • Smoking (tobacco use) accelerates the loss of bone mineral density, and can significantly increase the risk for osteoporosis to develop. The neurosurgeons at Charleston Brain and Spine understand quitting is extremely difficult, and can recommend therapies to help a patient stop smoking. 
  • Heavy alcohol consumption may inhibit new bone formation. New bone growth is essential to maintaining strong dense bones.
  • Genetics is an uncontrollable risk. Some of the risks include: parent/sibling with osteoporosis, being Asian or European, small-framed, or thin. Men and women who are small-framed have less bone mass. Thin women have less body fat; fat cells are involved in producing estrogen.
  • Endocrine problems: Hyperthyroidism, hyperparathyroidism, and Cushing’s syndrome are types of endocrinal disorders that contribute to osteopenia and osteoporosis.
  • Other diseases: Rheumatoid arthritis, multiple sclerosis, lupus, celiac disease, cancer and others.
  • Medications contributing to bone loss include: Aromatase inhibitors, anti-seizure drugs, steroids, thyroid replacement drugs, and overuse of antacids that contain aluminum. There are other drugs known to weaken bones.

Suggestion:Patients who take any of the medications listed above, should not stop taking their medication without speaking with their treating physician.

Diagnosis and Treatment of Osteoporosis

A DEXA scan is a screening test that measures bone mineral density. DEXA has become a standard of care for patients with certain risk factors that includes age. This simple test takes about 10 minutes. FRAX® is a newer tool combined with the DEXA scan results that predicts a patient’s fracture risk within a 10-year window.

Treatment may include medications to control osteoporosis, reduce bone loss, and maintain existing bone density. Of course, following a healthy meal plan and regular weight-bearing exercise as recommended by an osteoporosis healthcare provider is essential.


National Osteoporosis Foundation. www.nof.org. Accessed March 22, 2014.

The neurosurgeons at Charleston Brain and Spine can work with your treating primary care doctor or osteoporosis specialist. We routinely treat different types of spinal fractures using the most advanced and proven technologies. Contact us today for additional information.