Osteoporosis progresses without pain or obvious symptoms. Learn why it is called the "silent disease" and how you can catch it early.
Osteoporosis is often called the "silent disease." It progresses without pain or visible signs until a bone breaks. Many people only learn they have osteoporosis after a fracture from something as simple as a stumble or a sneeze.
Knowing about it helps. This article explains what osteoporosis is, what happens inside your bones, and how you can spot the warning signs early and act on them.
Imagine tripping on a curb, catching yourself with your hand, and finding out you have broken your wrist. At the hospital, the doctor says: "You have osteoporosis." For many people, this is the very first time they hear the word.
Osteoporosis usually causes no pain and no outward changes until a fracture occurs. High blood pressure is sometimes called the "silent killer" for the same reason: it weakens the body for years without warning.
Osteoporosis is often discovered only after a bone breaks. Knowing about the disease is the best way to prevent that first fracture.
Most people think "this could never happen to me." Knowing about osteoporosis can be the push to get screened early and start protecting your bones.
As we explain in more detail in Your Bones Are Alive, your bones are constantly being broken down and rebuilt in a process called bone remodeling. Cells called osteoclasts remove old bone, and cells called osteoblasts build new bone in its place. In healthy bones, these two processes are balanced.
With osteoporosis, the balance tips: bone is broken down faster than it can be rebuilt. Over time, this creates tiny gaps and holes inside the bone structure.
Think of a kitchen sponge. A new sponge has a fine, dense structure and feels firm. If its holes grew larger and larger, it would look the same size from the outside, but it would be weak and easy to crush. Bones with osteoporosis change in the same way.
Osteoporosis happens when the natural renewal of bone gets out of balance.
Osteoporosis is far more common than most people think. According to the International Osteoporosis Foundation (IOF):
In the United States alone, approximately 10 million people have osteoporosis, and another 44 million have low bone density (osteopenia), placing them at increased risk. In the United Kingdom, osteoporosis affects an estimated 3.5 million people, with over 500,000 fragility fractures occurring each year.
In US studies of postmenopausal women, fragility fractures were more common than heart attack, stroke, and invasive breast cancer combined (Women's Health Initiative Observational Study).
In Australia, approximately 1.2 million people are estimated to have osteoporosis, with a further 6.3 million having low bone density. Worldwide, up to 37 million fragility fractures happen every year in people aged over 55, about 70 fractures every minute.
Even so, many people with osteoporosis are never diagnosed or treated, because it causes no symptoms until a fracture happens. The International Osteoporosis Foundation estimates that as many as 80% of people who break a bone because of osteoporosis are never assessed or treated for the underlying disease. The figure varies a great deal between countries and between hospitals. This is sometimes called the "treatment gap" or "care gap."
Osteoporosis is a common condition. Asking yourself "could this affect me?" is a good first step.
Osteoporotic fractures tend to occur in four main areas of the body. These fractures can happen during everyday activities that would not break a healthy bone.
These are the most common osteoporotic fractures. A vertebra (one of the small bones that make up your spine) can collapse or become wedge-shaped, sometimes from something as minor as bending forward or lifting a grocery bag. About two-thirds of spinal compression fractures cause no immediate pain and go unnoticed. They are found later, when someone notices height loss or a change in posture.
Hip fractures are the most serious consequence of osteoporosis. They almost always need surgery and a hospital stay, and they can make it much harder to live independently. According to the IOF, up to 20-24% of people who suffer a hip fracture die within the first year, often due to complications. Among those who survive, many are unable to return to fully independent living.
A wrist fracture from a fall onto an outstretched hand is often the first sign of weakened bones. These fractures are more common in the years just after menopause (typically ages 50-65) and can be an early warning sign.
A fracture near the top of the upper arm bone can happen from a fall. It is less common than the other three, but it is a recognized osteoporotic fracture and can be painful and slow to heal.
Osteoporosis itself causes no pain, so watch for indirect signs that your bones may be changing:
Height loss: If you have lost more than 2 cm (about 1 inch) from your tallest adult height, this may indicate spinal compression fractures. Ask your doctor to measure your height accurately at your next visit.
Stooped posture (kyphosis): A gradual rounding of the upper back (sometimes called a "dowager's hump") can develop when multiple vertebrae lose height. Family members or friends may notice this before you do.
Clothes fitting differently: Shirts or blouses that seem longer on you, or a ribcage that sits closer to your hip bones, can be signs of height loss from spinal fractures.
A fracture from a minor incident: Breaking a bone from a fall from standing height or less (a "low-trauma fracture") is not normal at any age. If this happens, ask your doctor about osteoporosis screening.
These signs do not necessarily mean you have osteoporosis, but they are good reasons to talk to your doctor and consider a bone density test.
A hip fracture can mean emergency surgery, weeks or months of rehabilitation, and for some people a permanent loss of independence. According to the IOF, about 40% of people who suffer a hip fracture are unable to walk independently afterward, 60% still need help with everyday activities a year later, and about one in three become fully dependent on others or move into a care home.
Spinal compression fractures add up, even when they are painless. As the spine loses height and curves forward, it gets harder to reach high shelves or take a deep breath. Digestion can be affected too, as the rib cage moves closer to the pelvis.
Wrist fractures are less dangerous, but they get in the way of daily tasks such as writing, cooking, buttoning a shirt, or holding a grandchild's hand.
Fear of falling, loss of confidence, withdrawing from others, and depression are common after an osteoporotic fracture.
Preventing fractures protects your independence and your ability to keep doing the things you enjoy.
You do not need to wait for a fracture. Here are three steps you can take now:
Measure your height. Have someone measure your height accurately and compare it to your tallest recorded height. If you have lost more than 2 cm (1 inch), mention it to your doctor.
Try the wall test. Stand with your back against a flat wall. Can the back of your head touch the wall comfortably? If not, this may suggest changes in your spinal alignment. Learn more in our Wall Test article.
Ask your doctor about a DXA scan. A DXA (Dual-energy X-ray Absorptiometry) scan is a quick, painless test that measures your bone density. If you are a woman over 65, a man over 70, or have risk factors like a family history of fractures, talk to your doctor about getting scanned. Our DXA Guide explains the test in detail.
Q. Is osteoporosis curable?
Osteoporosis cannot be "cured" in the usual sense, but it can be managed well and even partly reversed. Medications can slow bone loss, stimulate new bone growth, and greatly reduce fracture risk. With good nutrition and exercise as well, many people with osteoporosis live active, fracture-free lives for decades.
Q. Is osteoporosis only a women's disease?
No. Osteoporosis is more common in women, especially after menopause, but men are affected too. Roughly 1 in 5 men over 50 will experience an osteoporotic fracture. Men tend to develop osteoporosis about 10 years later than women, but their fractures (especially hip fractures) often have worse outcomes. Osteoporosis screening should be considered for men with risk factors or those over 70.
Q. Can young people prevent osteoporosis?
Yes. Bone density peaks in your mid-to-late twenties. The stronger your bones are at their peak, the more "bone savings" you carry into later life. Young people can build strong bones through weight-bearing exercise, adequate calcium and vitamin D intake, and avoiding smoking. Think of it as a "bone bank": the more you deposit now, the more you can draw on later.
Q. I feel perfectly healthy. Could I still have osteoporosis?
Yes. That is why it is called the "silent disease." Feeling healthy does not mean your bones are strong. A DXA scan is the only reliable way to assess your bone density. If you have risk factors, such as being past menopause, having a family history of fractures, or taking corticosteroids long term, screening is strongly recommended even if you feel fine.
Barrett-Connor E, et al. Women's Health Initiative Observational Study — fracture incidence compared with cardiovascular events and invasive breast cancer in postmenopausal women.
International Osteoporosis Foundation. Epidemiology of osteoporosis and fragility fractures. https://www.osteoporosis.foundation/
International Osteoporosis Foundation (IOF). Osteoporosis Facts and Statistics. https://www.osteoporosis.foundation/facts-statistics
National Osteoporosis Foundation (NOF) / Bone Health & Osteoporosis Foundation. What is Osteoporosis and What Causes It. https://www.bonehealthandosteoporosis.org/
World Health Organization (WHO). Assessment of Fracture Risk and its Application to Screening for Postmenopausal Osteoporosis. Technical Report Series 843, 1994.
Kanis JA et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis International, 2019.
Wright NC et al. The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. Journal of Bone and Mineral Research, 2014; 29(11): 2520-2526.
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Medical Supervision
Hiroyuki Katoh（Orthopedic Surgeon, board-certified by the Japanese Orthopaedic Association）
Last updated:August 4, 2026