Osteoporosis causes the bones to become porous, making them look and act like thin, hollow sponges. Postmenopausal women, especially those of Asian and Caucasian descent with slender frames, face the most significant risk of developing the disease. Because osteoporosis lacks initial symptoms directly attributable to the condition, it is important to understand how it manifests in the earlier stages, to identify and slow the progression.


While joints and connective tissue provide flexibility, muscles provide strength to move the body. In older adults with the condition, osteoporosis makes bones weaker and more prone to injury, which affects how the surrounding muscles work. Muscles can lose their ability to contract and become less toned. Low muscle tone or hypotonia leads to reduced strength, contributing to atrophy. Loss of muscle leads to lower lean body mass and less protection against external impacts, which leads to bones fracturing more easily.

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Receding Gums

People usually think of osteoporosis affecting common fracture sites such as the hip and wrist, but the jaw bone that anchors the teeth can also be impacted by this disease. Bone loss in the jaw leads to loose dentures, gums detaching from teeth, and periodontitis, an infection of the gum and bones. Studies show periodontitis has a stronger link to osteoporosis than previously thought. Some studies also suggest that low bone density increases the risk of periodontitis.

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Weak Grip

Handgrip is one of the best ways to gauge muscle strength and can help doctors determine the impact of osteoporosis. A Korean study of postmenopausal women found a correlation between low bone mass density and handgrip strength. Specifically, doctors associate low grip strength in the dominant hand with reduced spine, neck, and hip bone mass densities.

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The abnormal convex curvature of the upper spine leading to hunched shoulders is kyphosis. In those with osteoporosis, kyphosis is the result of compression fractures of cervical and thoracic vertebrae; the symptom can cause sharp pain or none at all. Repeated breaks in this part of the spine cause the curve, resulting in height loss. If kyphosis becomes more severe, it can result in a significant bump at the base of the neck, called a dowager's hump.

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Brittle Nails

Studies show that nails may indicate bone health, highlighting protein and mineral deficiencies that standard tests might miss. Bone and nails contain both the protein keratin and collagen type 1, which also forms the strong fibers found in ligaments and tendons. Tests done on nail samples from women with and without osteoporosis showed that nails from those with osteoporosis had 25 percent less keratin, making them weaker and less resilient.

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Loss of Height

Most people expect to lose some height as they age. However, those who lose ¾ inch quite quickly, or a total of 2.5 inches since young adulthood may have osteoporosis. Fractures or breaks in the vertebrae can result in a decrease of up to 20% of vertical bone height. This process is called vertical compression, and it causes pain in addition to significant height loss.

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Hearing Loss

The malleus, incus, and stapes are the three tiny bones in the middle ear that transmit sound. As people age, they become more susceptible to hearing loss, in part due to the degradation of these vital bones. Research suggests that those 50 years and older with osteoporosis are more at risk of acute sensorineural hearing loss. Doctors hypothesize that changes in the flow of calcium ions disturbs electrical balances in the ear, resulting in the loss of auditory cells.

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Osteoporosis-pseudoglioma is a rare genetic form of osteoporosis that leads to vision loss. A mutation in the LRP5 gene that assists with bone density and retinal development causes this symptom. Studies show that the mutation leaves eyes without a properly formed retina, resulting in children born with vision abnormalities and thinned bones.

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Scoliosis is the S-curve misshaping of the spine that results in a side-to-side shift or forward or backward bend. The condition is usually associated with children, but adult-onset scoliosis develops due to many factors, including weak bones. Adult-onset scoliosis is more likely to show up in women after menopause, as bone loss occurs. Scoliosis in adults can cause severe symptoms or none at all.

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Fragility Fractures

Fragility fractures are the most common symptom of osteoporosis, occurring when weakened bones fracture from minimal trauma. These kinds of fractures happen during falls from standing height or lower. They can even happen from a bump, strain, or coughing; in some cases, this type of injury is the first indication of weakened bones. Data suggests that about13 percent of men and 40 percent of women with osteoporosis will experience a fragility fracture in their lifetime. Men also have a higher rate of mortality from fragility fractures relative to women.

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