Bone & Joint

Osteoporosis

Osteoporosis is a common condition where bones become weaker and more likely to break, often without symptoms until a fracture occurs. Early detection helps reduce risk and preserve your quality of life.

Osteoporosis is a common bone condition that causes bones to become less dense and more fragile, increasing the risk of fractures. It often develops slowly over many years and may not show symptoms until a bone breaks. The condition is most common in older adults and postmenopausal women but can also affect men and younger people, especially if other health conditions or certain medications are involved.

Signs and Symptoms
Osteoporosis is sometimes called a “silent disease” because there may be no warning signs until a fracture occurs. Possible indicators include:

  • Unexplained back pain (sometimes from a vertebral fracture)
  • Loss of height over time
  • A stooped posture
  • Fractures from minor falls or even simple actions like coughing

Causes and Risk Factors

  • Age-related bone loss
  • Decreases in sex hormones, particularly estrogen after menopause
  • Low calcium or vitamin D intake
  • Sedentary lifestyle
  • Smoking or heavy alcohol use
  • Low body weight
  • Certain medications, such as long-term glucocorticoids
  • Medical conditions like rheumatoid arthritis, hyperthyroidism or celiac disease

Diagnosis
Diagnosis typically starts with a review of your health history and risk factors. The main test is a DXA (dual-energy X-ray absorptiometry) scan of the hip and spine, which measures bone mineral density and provides a T-score:

  • Normal: T-score above -1
  • Low bone mass (osteopenia): T-score -1 to -2.4
  • Osteoporosis: T-score -2.5 or lower

Additional lab tests or risk calculators like FRAX may be used to guide treatment decisions.

Treatment and Management
The primary goal is to reduce fracture risk. Management strategies may include:

  • Ensuring adequate calcium and vitamin D
  • Weight-bearing and strength-training exercises
  • Fall prevention at home
  • Quitting smoking and limiting alcohol
  • Medications to slow bone loss or help build bone when recommended by your practitioner

Early diagnosis and treatment can help protect bone health and maintain quality of life.

What is osteoporosis?
Osteoporosis is a condition where bones weaken and are more likely to fracture. Diagnosis usually involves a DXA scan and review of risk factors.

Who is most at risk?
Postmenopausal women, older adults, those with a family history of osteoporosis or fractures, people with low body weight, smokers, heavy drinkers, or those taking long-term corticosteroids. Certain chronic conditions may also increase risk.

What are the symptoms?
Osteoporosis often has no symptoms until a fracture occurs. Possible signs include sudden back pain, height loss, a stooped posture or fractures from minor stresses.

How is it diagnosed?
A DXA scan measures bone density and provides a T-score. Lab tests may check calcium, vitamin D, thyroid function, and other factors. Tools like FRAX help guide treatment.

Can osteoporosis be prevented?
Yes. Strategies include getting enough calcium and vitamin D, staying active with weight-bearing and resistance exercises, avoiding tobacco, limiting alcohol, maintaining a healthy weight, and managing conditions affecting bone health.

What treatments are available?
Treatment depends on fracture risk and may include medications such as bisphosphonates, denosumab, SERMs or parathyroid hormone analogs. Your provider will tailor therapy to your needs.

Are there side effects of osteoporosis medications?
Yes. Bisphosphonates can cause stomach upset and rarely jaw or thigh bone issues. Denosumab may increase infection risk. Bone-building agents have usage limits and specific side effects. Discuss risks and benefits with your provider.

How often should I get a bone density test?
Frequency depends on your results and risk. Normal bone density may not require retesting for up to 10 years, while low bone mass or ongoing therapy may need testing every 1–3 years.

When should I see a doctor about bone health?
Seek evaluation if you have risk factors, previous fractures, long-term steroid use, early menopause, or notice height loss or back pain. Early care can help prevent fractures.

What can I do at home to lower fracture risk?

  • Eat a diet with adequate calcium and vitamin D
  • Exercise regularly with weight-bearing and resistance activities
  • Prevent falls by improving home safety
  • Avoid tobacco and limit alcohol
  • Follow your practitioner's guidance on medications and checkups