Osteoporosis

What is osteoporosis?

Osteoporosis is a disease in which your bones become weak and are likely to fracture (break). The disease can develop when your bone mineral density and bone mass decrease. It can also happen if the structure and strength of your bones change.

Osteoporosis is called a "silent" disease because it doesn't usually cause symptoms. You may not even know you have the disease until you break a bone. This could happen with any bone, but it's most common in the bones of your hip, vertebrae in the spine, and wrist.

What causes osteoporosis?

Your bones are made of living tissue. To keep them strong, your body breaks down old bone and replaces it with new bone. Osteoporosis develops when more bone is broken down than replaced. You lose bone mass and changes happen in the structure of your bone tissue. This can happen as you get older. Other risk factors can also lead to the development of osteoporosis or increase your chance of developing the disease.

Who is more likely to develop osteoporosis?

Anyone can develop osteoporosis, but you are more likely to develop it if you have one or more of risk factors:

• Your sex. Osteoporosis is more common in women.
• Your age. Your risk increases as you get older. It is most common in people over age 50.
• Your body size. It is more common in people who are slim and thin boned.
• Your race:
  • White and Asian women are at highest risk.
  • African American and Mexican American women have a lower risk.
  • White men are at higher risk than African American and Mexican American men.
• Family history. Your risk of osteoporosis may be higher if one of your parents has osteoporosis or broke their hip.
• Changes to hormones. Low levels of certain hormones can increase your chance of developing osteoporosis.
• Diet. A diet that is low in calcium and/or vitamin D or does not include enough protein can raise your risk.
• Long-term use of certain medicines, such as:
  • Corticosteroids
  • Proton pump inhibitors (which treat GERD)
  • Medicines to treat epilepsy
• Having other medical conditions, such as:
  • Endocrine diseases
  • Certain digestive diseases
  • Rheumatoid arthritis
  • Certain types of cancer
  • HIV
  • Anorexia nervosa, a type of eating disorder
• Your lifestyle. Certain lifestyle factors can contribute to bone loss, such as:
  • Smoking tobacco
  • Long-term heavy alcohol use
  • Physical inactivity or prolonged periods of bedrest

What are the symptoms of osteoporosis?

Osteoporosis usually doesn't cause symptoms. You may not know that you have it until you break a bone.

How is osteoporosis diagnosed?

Health care providers usually diagnose osteoporosis during routine screening for the disease. The U.S. Preventive Services Task Force recommends screening for:

• Women over age 65
• Women of any age who have factors that increase the chance of developing osteoporosis

The Task Force does not recommend regular screening for men.

To find out if you have osteoporosis, your provider:

• Will ask about your medical history and whether you have ever broken a bone
• May do a physical exam, which could include checking for:
  • A loss of height and/or weight
  • Changes in your posture
  • Balance and gait (the way you walk)
  • Your muscle strength
• Will likely order a bone density scan

What are the treatments for osteoporosis?

The goals for treating osteoporosis are to slow or stop bone loss and to prevent fractures. Your provider may recommend:

• A healthy, balanced diet that includes enough calcium, vitamin D, and protein
• Lifestyle changes such as quitting smoking and limiting alcohol
• Regular physical activity
• Fall prevention to help prevent fractures
• Medicines, such as:
  • Medicines that slow down bone loss
  • Medicines that help rebuild bone

In addition to managing your osteoporosis, it's important to avoid activities that may cause a fracture. These can include movements that involve:

• Twisting your spine, like swinging a golf club
• Bending forward from the waist, like sit ups and toe touches

You can also help reduce the risk of breaking a bone by preventing falls.

Can osteoporosis be prevented?

To help keep bones strong and help prevent osteoporosis, the best thing to do is to eat a healthy diet rich in calcium and vitamin D. Getting regular physical activity, limiting alcohol, and not smoking can also help.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases