Aging & Health A to Z
Causes & Symptoms
Most fractures in older people are caused by the combination of weak bones (such as from osteoporosis) and a fall. As you get older, your bones get weaker from natural bone tissue changes. After menopause, the decline in the female hormone estrogen also makes your bones thinner. Other medical conditions, medications, cigarette smoking, alcohol, and your genetic predisposition may all contribute to more severe loss of bone with aging. In addition, your risk of falling increases because your balance and vision become less acute, reflexes slow down, and coordination worsens.
When bones become frail and brittle, even a small move can be enough to cause a fracture. For example, lifting something, bending forward, or stepping down harder than usual may cause a vertebral fracture (break in one of the bones of your back).
Simply getting older increases your risk of sustaining a fracture. But if you have any of the following conditions, your chances rise:
- Osteoporosis or osteopenia (loss of bone mass)
- Diseases of the bones such as Paget’s disease, cancer, or rheumatoid arthritis
- Kidney failure requiring dialysis
- Medications (e.g., long-term medicines used for asthma [prednisone and other corticosteroids], high blood pressure, seizures, breast cancer, thyroid conditions, blood thinners, anxiety medications, sleeping pills)
- Female gender
- White race
- Intestinal problems that prevent you from absorbing nutrients well
- Long-term alcohol misuse or tobacco habit
- Inactive (sedentary) lifestyle
- Hyper-thyroid and hyper-parathyroid disease
- Osteomalacia (a bone disorder related to inadequate vitamin D in older people)
- History of prior fracture
- Parent(s) with history of hip fracture
Symptoms and Warning Signs
Usually, fractures are extremely painful and unmistakable. There is deep pain and tenderness around the site of the fracture, and pain may radiate to neighboring areas of the body if the fracture is in your spine. Standing and sitting may be particularly painful. However, sometimes you will not feel any symptoms. You may also have pain before the fracture occurs if your bones are weak from osteoporosis or another chronic disease.
Some fractures, including compression fractures of the spine, may not cause pain and will only be noticed on an x-ray. You may find, however, that you are getting shorter or that your shape is changing. Your upper back may protrude in a “widow’s hump” (kyphosis). These may signal compression fractures of the bones in your back.
Updated: January 2017
Posted: March 2012