In this article, learn more about osteoporosis, its sources of pain, and how to cope.
Sources of Osteoporosis Pain
Pain from osteoporosis varies in intensity and depends on its exact cause. Typically, fractures account for osteoporosis-related pain, but certain medications can also cause pain.
Stress Fractures
A stress fracture is a tiny break in a bone, usually due to repetitive movement. Over time, if a muscle group is overused or a force is repeatedly applied, it may transfer some of this force to the nearby bones, which in time, may become unable to absorb the pressure and crack.
People with osteoporosis develop stress fractures more easily because their bones are more brittle and unable to absorb this extra force.
Compression Fractures
A compression fracture occurs when the vertebrae (bones in the spine that stack on top of each other and protect the spinal cord) become weakened and collapse into each other. Osteoporosis is the most common cause of spinal compression fractures.
Compression fractures cause back pain that can either come on slowly or be sudden and severe. Some compression fractures also press on the nerves, which can cause nerve pain. Additionally, some people with compression fractures develop a hunchback (called dorsal kyphosis), which can also cause pain and limit movement.
Trabecular Microfractures
Trabecular bone is the porous, spongy bone tissue inside a bone that surrounds the marrow. Microfractures of this tissue are common among people with osteoporosis.
Medication Side Effects
Ironically, some medications that treat osteoporosis may cause bone pain as a side effect.
Medications that treat osteoporosis, whose side effects may include bone, muscle, and joint pain, include:
Bisphosphonates (medications that reduce bone loss) Xgeva and Prolia (denosumab) (biological medicines derived from living organisms)
How to Manage Osteoporosis Pain
There are several ways to manage osteoporosis-related pain, including medication, physical therapy, exercise, and more.
Medication
Sometimes, analgesic (pain-relieving) medications treat osteoporosis-associated pain. This could result from sudden pain from a broken bone or chronic pain. Different medications may be recommended based on pain level, cause, and duration.
Medications that treat osteoporosis pain may include:
Mild pain: Non-steroidal anti-inflammatory drugs (NSAIDs) or Tylenol (acetaminophen) Moderate pain: Weak opioids with or without NSAIDs or acetaminophen; adjuvant therapy Strong pain: Opioids with NSAIDs or acetaminophen; adjuvant therapy
Heat and Ice
Applying heat or cold therapies may help relieve some pain from osteoporosis. Examples include heating pads, ice packs, hot or cold plunge pools, and ultrasound. Alternating hot and cold may also help.
Consulting a healthcare provider before using heating or cooling therapies is recommended. Some methods may be contraindicated; for example, it is better to use cold therapy immediately after breaking a bone to reduce inflammation and swelling.
Thermal therapies may not be recommended for people with nerve involvement. Using very cold or very hot packs may also cause burning or other side effects.
Bracing
A brace is a wearable device that supports your bones and muscles and limits movement to varying degrees. Sometimes, your healthcare provider may recommend a brace to heal and support osteoporosis-associated fractures. Back braces are commonly recommended for people with compression fractures.
Physical Therapy
Your healthcare provider may recommend physical therapy if you have pain from osteoporosis-related fractures. A physical therapist can prescribe a personalized evidence-based exercise regimen that includes weight-bearing and resistance exercises designed to manage your pain, prevent further postural deformity, and prevent bone density loss.
Occupational Therapy
You may also be referred to an occupational therapist who specializes in enabling people to perform activities that are meaningful to them.
If you have osteoporosis, they may help you modify your home environment, recommend adaptive equipment, or recommend ways of performing your activities of daily living—such as showering, dressing, or eating—in a way that reduces pain. They may also offer advice about how to reduce your risk of falls, which are extremely dangerous for people with osteoporosis.
Exercise
Exercise, particularly weight-bearing and resistance exercises, can help slow bone loss. Some activities with evidence to support them for osteoporosis include:
YogaPilatesWuqinxi (a Chinese mind-body exercise)
However, exercise can also be painful for people with osteoporosis and may even lead to the stress fractures they try to avoid. That’s why consulting with a physical therapist or another orthopedic health professional before starting a new exercise program with osteoporosis is recommended.
Complementary Therapy
Some complementary approaches may also help you manage osteoporosis-related chronic pain.
Acupuncture, a Chinese medicine that involves sticking thin needles into strategic “energy channels” along the body, can improve pain and bone mineral density among people with osteoporosis.
Other recommended therapies include the following:
Massage Biofeedback (a form of therapy that can help you gain control over involuntary body processes that block pain) Relaxation techniques Behavior modifications Transcutaneous electric nerve stimulation (TENS) units (applying an electrical current that can block pain)
When to Seek Care
Osteoporosis is considered a “silent disease” until it’s not. There are usually no signs of osteoporosis until you get an often very painful bone fracture. Screening for osteoporosis is important and can help prevent fractures and osteoporosis pain.
Consider speaking to a healthcare provider if you have new pain (whether it comes on suddenly or gradually) or posture changes. They can perform a bone density scan if you are not already diagnosed with osteoporosis.
Summary
It is essential to diagnose and treat osteoporosis to prevent painful fractures. Some treatments, such as medication, physical or occupational therapy, heat or ice therapy, bracing, and exercise, can help manage chronic pain due to osteoporosis.
A Word From Verywell
You are not alone if you have osteoporosis and pain. Osteoporosis itself is not a painful condition. However, it can lead to stress fractures, compression fractures, and other fractures that can be incredibly painful when they occur or even cause long-term pain.
