By Vanessa Caceres 

 Medically reviewed by Stella Bard, MD

Osteoporosis can lead to complications impacting a person's quality of life by making it harder to do certain activities. Complications include fractures and broken bones, pain, issues with posture, and limited mobility. A person with osteoporosis may withdraw from regular social contact and feel depressed.

This article discusses osteoporosis symptoms and complications. It also addresses related complications, such as kyphosis, treatments for osteoporosis, and the long-term outlook for living with this condition.

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Osteoporosis Symptoms

Symptoms of osteoporosis include:1

• Back pain

• Loss of height

• Small breaks in the bones that may feel like muscle or joint pain

• Minor falls

• Hunched posture

Sometimes, osteoporosis has no symptoms until a fracture occurs or one of the bones in the back collapses.2

Complications of Osteoporosis

Osteoporosis has a few common complications, including the following.

Fractures

Fifty percent of women and 25% of men with osteoporosis will break a bone at some point.3 Globally, there are more than 8.9 million fractures each year from osteoporosis.4

People with osteoporosis have fragile bones, putting them at a higher risk for fracture, which can happen during a fall or other minor injuries. However, they can also occur during daily activities, including bending, lifting, or even sneezing.2

The most common fracture in osteoporosis is a vertebral compression fracture. With this, the vertebrae (the bones making up the spine) collapses, leading to pain and changes in height. Vertebral compression fractures affect 750,000 people in the United States each year.5

Pain

Although you may not have pain directly from the condition, osteoporosis-related fractures can cause pain. You may also have continuing pain after a fracture in your neck and mid or lower back.6

A condition called kyphosis may also cause pain when you have osteoporosis. With kyphosis, there is a noticeable curvature of the spine that gives a hunchbacked appearance. The pain comes from strained and stressed muscles, ligaments, and tendons in the back.7

Issues With Posture

Small fractures in the bones of the spine are not uncommon with osteoporosis. Multiple fractures can lead to the forward-curving, hunched appearance of kyphosis. Very bad kyphosis may push the stomach forward and can limit the space for internal organs. When this happens, it can become harder to breathe and eat.7

Limited Mobility

Fractures may limit mobility when you have osteoporosis, making it harder, if not impossible, to move the injured area of the body.

Sometimes, recovering from a fracture can cause a cycle of limited mobility. Other body parts become weaker too, which may lead to less interest in moving around and getting exercise. In turn, this prolonged inactivity limits mobility even further.8

Decreased Quality of Life

Not everyone with osteoporosis experiences a decreased quality of life. That's because not everyone faces multiple fractures, limited mobility, and pain associated with the condition.9

However, for those with more painful symptoms from osteoporosis, their quality of life may be negatively affected due to limitations, such as feeling like they can't be as socially active as they once were.

If you feel depressed from osteoporosis, you may also isolate yourself from others more often. You may intentionally (or unintentionally) distance yourself from close family members, including your spouse, for fear of causing a fracture with any physical contact.9

Managing Complications

Osteoporosis can be difficult to manage when you have complications. Talk to your provider about resources to help you live a better life with osteoporosis.

Medication Side Effects

The medications used for osteoporosis can slow down the loss of bone and even help improve your bone mineral density. These medications, however, can also cause certain side effects, including:10

• Pain in the bones, joints, or muscles

• Difficulty swallowing

• Stomach ulcer

• Heartburn

• Nausea

The exact side effects will differ depending on the medication used.

One class of medication for osteoporosis is called bisphosphonates. In rare cases, bisphosphonates may cause jaw osteonecrosis, which is permanent damage to the jawbone. It is predominantly seen in people with a recent dental procedure or dental disease or who had high-dose IV bisphosphonates for cancer.11

Another rare side effect of bisphosphonates is atypical thighbone (femoral) fractures.11

Related Conditions

Some conditions related to osteoprosis include osteoarthritis, kyphosis, and depression.

Osteoarthritis

Although they have similar names that share the prefix "osteo," meaning "bone," osteoporosis and osteoarthritis are not the same. Osteoporosis refers to bone loss, while osteoarthritis, the most common type of arthritis, is the weakening of joints that can worsen over time.12

It's possible to have both osteoporosis and osteoarthritis. Osteoarthritis can be painful, whereas osteoporosis may not have any associated pain unless a fracture occurs.

Kyphosis

Kyphosis refers to the appearance of the spine in a forward curvature or humped back appearance. When measured using an X-ray, the spine's curvature measures 50 degrees or more compared to 20 to 45 degrees for a normal spine curvature.

One potential risk factor for the development of kyphosis is osteoporosis. It's also more common if you have a family member with kyphosis.13

Depression

It's common to experience depression when you have osteoporosis, especially if osteoporosis affects your quality of life. Some symptoms of depression include feeling:14

• Persistently sad

• Irritable

• Fatigued

• Disinterested in activities you usually enjoy

• Difficulty sleeping or oversleeping

You may feel some symptoms of depression, but not all of them. If you think you are depressed, talk to a trusted friend or family member. Discuss options for talk therapy or medications that may help with your healthcare provider. Talking about osteoporosis may lead you to find better ways to cope with it.

Causes and Risk Factors

Osteoporosis can have several causes:

• Certain medications, including cancer chemotherapy drugs, corticosteroids, proton pump inhibitors, methotrexate, and others, are associated with bone loss.15

• Autoimmune disorders like lupus or rheumatoid arthritis, cancer, or neurological conditions like Parkinson's disease or stroke can raise your risk for the development of osteoporosis.

• Having risk factors that increase the chance for the development of osteoporosis.

Factors that increase the prevalence of osteoporosis include:1

• Sex

• Age

• Body size

• Race

• Family history

• Hormone changes

• Diet

• Medical conditions

• Lifestyle

Treatment and Long-Term Outlook

Osteoporosis treatment aims to slow bone loss and lower your risk for fractures. Treatment for osteoporosis typically involves a healthy lifestyle and exercise. It also may include the use of certain medications. Specifically, the treatments for osteoporosis include:16

• A healthy diet that includes calcium, protein, and vitamin D can help prevent bone loss.

• Physical activity, including strength training and balance exercises, reduces your risk for falls and fractures.

• Certain prescription medications can decrease your risk, including bisphosphonates, calcitonin, or a selective estrogen receptor modulator.

Although osteoporosis may significantly impact your life, it is possible to treat it with diet, exercise, and medications.

Summary

Osteoporosis-related complications include pain, fractures, limited mobility, and decreased quality of life. Both kyphosis and depression can be associated with osteoporosis.

Certain medications and health conditions can raise the risk of bone loss and osteoporosis. Treatment for osteoporosis includes a healthy diet, safe physical activity, and medicines that slow down bone loss or improve bone mineral density.

Managing osteoporosis and complications can take some planning to ensure you have healthier meals and time for consistent and safe physical activity. Finding the medications that help with your bone loss can also be a balancing act without causing too many unwanted side effects.

Talk to your healthcare provider if you need help managing osteoporosis, as many resources are available. Your healthcare team is there to help you.

 Sources

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Osteoporosis.

NIH National Osteoporosis and Related Bone Diseases National Resource Center. Osteoporosis overview.

National Osteoporosis Foundation. Osteoporosis fast facts.

International Osteoporosis Foundation. Epidemiology of osteoporosis and fragility fractures.

American Association of Neurological Surgeons. Vertebral compression fractures.

Department of Health, Australia. Osteoporosis and osteopenia.

Bone Health and Osteoporosis Foundation. Osteoporosis and your spine.

NIH Osteoporosis and Related Bone Disease National Resource Center. Bed rest and immobilization: risk factors for bone loss.

Bone Health & Osteoporosis Foundation. Overall health.

Bone Health and Osteoporosis Foundation. Side effects of bisphosphonates.

American College of Rheumatology. Osteoporosis.

Osteoporosis Canada. Osteoporosis and osteoarthritis.

Johns Hopkins Medicine. Kyphosis.

National Institute of Mental Health. Depression.

Bone Health and Osteoporosis Foundation. What is osteoporosis and what causes it?

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Osteoporosis: Diagnosis, treatment, and steps to take.

UF Health. Medicines for osteoporosis.

NIH Osteoporosis and Related Bone Diseases National Resource Center. Bone mass measurement: What the numbers mean.

By Vanessa Caceres
Vanessa Caceres is a nationally published health journalist with over 15 years of experience covering medical topics including eye health, cardiology, and more.