Signs and Symptoms
Osteoporosis is often called a silent condition because bone loss itself does not hurt. Signs that it may be present include:
- A fracture from a fall from standing height or less, such as a broken wrist or hip
- Sudden back pain, especially after bending, lifting or a minor fall, which can be a compression fracture (a vertebra that has collapsed)
- Loss of height over time
- A forward curve of the upper back (kyphosis) or a stooped posture
What Causes It?
Bone is constantly broken down and rebuilt. Osteoporosis develops when loss outpaces rebuilding. Risk increases with age and is higher in women after menopause because estrogen levels drop. Other risk factors include a family history of osteoporosis or hip fracture, small body frame, smoking, heavy alcohol use, low calcium or vitamin D intake, limited physical activity, and long-term use of certain medications such as oral steroids. Some medical conditions, including rheumatoid arthritis and certain hormone disorders, also raise the risk.
How We Diagnose It at POPB
Osteoporosis is usually diagnosed with a bone density test (DXA scan), a low-dose X-ray that measures bone mineral density at the hip and spine. Your doctor may also estimate your 10-year fracture risk using your age, health history and test results. If you have sudden back pain, Dr. Baskin can evaluate you for a compression fracture with X-ray and MRI in our office; MRI can help show whether a fracture is recent.
We also look at why a fracture happened. Our fall-risk assessment checks your balance, strength, walking and home safety factors.
Non-Surgical Treatment Options
Protecting your bones involves several steps working together:
- Weight-bearing and strength exercise, guided by our physical therapists, to support bone and muscle
- Balance training and our fall prevention program to lower your chance of falling
- Adequate calcium and vitamin D, from food or supplements as your doctor advises
- Stopping smoking and limiting alcohol
- Bone-strengthening medications when appropriate. These are chosen and prescribed in coordination with your primary care physician or endocrinologist, who often manage long-term osteoporosis treatment.
Many compression fractures heal with a short period of pain control, activity modification, sometimes a back brace, and physical therapy.
Surgical Options
For a painful spinal compression fracture that is not improving with conservative care, Dr. Baskin may recommend kyphoplasty. In this minimally invasive procedure, he uses fluoroscopy (live X-ray) to guide a small balloon into the fractured vertebra, inflates it to create space, and fills that space with bone cement to stabilize the bone. Dr. Baskin performs kyphoplasty for thoracic and lumbar compression fractures in our procedure suite. Not every fracture is a good fit, and he will review whether it makes sense for you.
Fractures of the hip, wrist and other bones are treated by the appropriate specialist on our team, with surgery performed at the hospitals and surgery centers where our surgeons operate.
Recovery
A compression fracture treated without a procedure often improves over six to twelve weeks. After kyphoplasty, many people notice pain relief within days, though results vary. Because one fragility fracture raises the risk of another, recovery also means long-term bone health: exercise, fall prevention and follow-up with your primary care physician or endocrinologist on medication.
Insurance and Cost
Medicare and most commercial plans cover bone density testing at set intervals for people who meet certain criteria, and they generally cover evaluation, imaging and physical therapy when medically necessary. Kyphoplasty is typically covered when criteria are met and often needs prior authorization. HMO and managed-care plans require a referral in our office before your visit. Our staff verify benefits when you call.
When to Be Seen
Call our office if you have new back pain after a minor fall or lift, have lost height, have had a fracture from a simple fall, or are worried about your balance.
Go to the emergency room or call 911 if you cannot bear weight after a fall, a limb looks deformed, or back pain comes with loss of bladder or bowel control, numbness in the groin or inner thighs, or leg weakness.
