Osteoporosis is a bone disease. Its name comes from Latin for "porous bones."
The inside of a healthy bone has small spaces, like a honeycomb. Osteoporosis increases the size of these spaces, causing the bone to lose strength and density. In addition, the outside of the bone grows weaker and thinner.
Osteoporosis can occur in people of any age, but it’s more common in older adults, especially women. More than 53 million people in the United States either have osteoporosis or are at high risk of developing it.
People with osteoporosis are at a high risk of fractures, or bone breaks, while doing routine activities such as standing or walking. The most commonly affected bones are the ribs, hips, and the bones in the wrists and spine. Read more about how osteoporosis affects your bones.
The early stages of osteoporosis don’t cause any symptoms or warning signs. In most cases, people with osteoporosis don’t know they have the condition until they have a fracture.
If symptoms do appear, some of the earlier ones may include:
- receding gums
- weakened grip strength
- weak and brittle nails
If you don’t have symptoms but have a family history of osteoporosis, talking to your doctor can help you assess your risk. Learn more about possible symptoms and when to see your doctor.
Without appropriate treatment, osteoporosis can worsen. As bones get thinner and weaker, the risk of fracture increases.
Symptoms of severe osteoporosis can include a fracture from a fall or even from a strong sneeze or cough. They can also include back or neck pain, or loss of height. These last two symptoms can be caused by a compression fracture. This is a break in one of the vertebrae in your neck or back, which is so weak that it breaks under the normal pressure in your spine.
If you do have a fracture from osteoporosis, how long it takes to heal will depend on many factors. These include where the fracture is, how severe it is, as well as your age and health history. Learn more about the different types of fractures and how they’re treated.
To understand osteoporosis, it can help to see what normal bone looks like versus bone affected by osteoporosis.
A few key causes lead to most cases of osteoporosis.
In osteoporosis, your bones become weak and more likely to fracture. Often people do not know they have the condition until they break a bone—most commonly in the wrist, hip, or spine. That's why it is important to take steps to keep your bones strong and find out if you are at risk for fractures.
Another primary cause of osteoporosis is menopause, which occurs in women around the ages of 45 to 55 years. Due to the change in hormone levels associated with it, menopause can cause a woman’s body to lose bone even more quickly.
Men continue to lose bone at this age, but at a slower rate than women do. However, by the time they reach the ages of 65 to 70, women and men are usually losing bone at the same rate.
Medical conditions or medications
Other causes of osteoporosis include certain medical conditions such as hyperthyroidism. They also include the use of certain medications. Examples of these medications include long-term oral or injected corticosteroids such as prednisone or cortisone.
Age, menopause, certain health conditions, and the use of certain medications may be the primary causes of osteoporosis, but they’re not the only ones. Read more about these and other causes of osteoporosis, as well as the role of vitamin D in bone health.
The biggest risk factors for osteoporosis include:
- being female
- being an older adult
- being Caucasian or Asian
- having a family history of osteoporosis
- poor nutrition
- physical inactivity
- taking certain medications
- low body weight
- small-boned frame
You can control some of these risk factors for osteoporosis, such as poor nutrition and inactivity. For instance, improving your diet and starting an exercise program can benefit your bone health. However, you can’t control other risk factors, such as your age or gender. Learn more about all of these risk factors, and ways to lower your risk of osteoporosis.
You may have heard of senile osteoporosis. This isn’t a separate type of this disease — it’s simply osteoporosis that’s caused by aging. As mentioned above, age is a primary cause of osteoporosis. Unless proper prevention or treatment efforts are made, your body’s increasing breakdown of bone can lead to weakened bones and osteoporosis.
According to global statistics from the International Osteoporosis Foundation, about one-tenth of women aged 60 have osteoporosis, while two-fifths of women aged 80 have the disease.
To check for osteoporosis, your doctor will review your medical history and do a physical exam. They may also run tests of your blood and urine to check for conditions that may cause bone loss. If your doctor thinks you may have osteoporosis or that you’re at risk of developing it, they’ll likely suggest a bone density test.
This test is called bone densitometry, or dual-energy X-ray absorptiometry (DEXA). It uses X-rays to measure the density of the bones in your wrists, hips, or spine. These are the three areas most at risk of osteoporosis.
This painless test can take from 10 to 30 minutes. Learn what to expect during a bone density test and how to prepare for it.
If your testing shows that you have osteoporosis, your doctor will work with you to create a treatment plan. Your doctor will likely prescribe medications as well as lifestyle changes. These lifestyle changes can include increasing your intake of calcium and vitamin D, as well as getting appropriate exercise.
There’s no cure for osteoporosis, but proper treatment can help protect and strengthen your bones. These treatments can help slow the breakdown of bone in your body, and some treatments can spur the growth of new bone. Find out more about how treatment can help support the health of your bones.
The most common drugs used to treat osteoporosis are called bisphosphonates. Bisphosphonates are used to prevent the loss of bone mass. They may be taken orally or by injection. They include:
Other medications may be used to prevent bone loss or stimulate bone growth. They include:
- Testosterone: In men, testosterone therapy may help increase bone density.
- Hormone therapy: For women, estrogen used during and after menopause can help stop bone density loss. Unfortunately, estrogen therapy has also been associated with increased risk of blood clots, heart disease, and certain types of cancer.
- Raloxifene (Evista): This medication has been found to provide the benefits of estrogen without many of the risks, although there is still an increased risk of blood clots.
- Denosumab (Xgeva or Prolia): This drug is taken by injection and may prove even more promising than bisphosphonates at reducing bone loss.
- Teriparatide (Forteo): This drug is also taken by injection and stimulates bone growth.
- Calcitonin salmon (Fortical and Miacalcin) This drug is taken as a nasal spray and reduces bone reabsorption. Talk to your doctor about any increased risk of cancer with this drug.
Prescription medication is the most aggressive way to treat osteoporosis. Learn about other medications used to treat osteoporosis, as well as possible side effects.
Because osteoporosis medications can have side effects, you may prefer to try other treatments instead of medication.
Several supplements, such as red clover, soy, and black cohosh, may be used to help promote bone health and ease the symptoms of osteoporosis. However, before using these supplements, be sure to talk to your doctor or pharmacist. This is for two main reasons:
- There are few, if any, studies supporting the use of these supplements for treating osteoporosis. As a result, we don’t have proof that they work.
- These supplements can cause side effects, as well as interact with medications you’re taking. You’ll want to make sure you know what side effects could occur, and if you’re taking any medications that could interact with the supplement.
All of that said, some people report good results with natural treatments. Learn more about the natural treatment options available, as well as the risks associated with them.
In addition to your treatment plan, an appropriate diet can help strengthen your bones.
To keep your bones healthy, you need to include certain nutrients in your daily diet. The most important ones are calcium and vitamin D. Your body needs calcium to maintain strong bones, and it needs vitamin D to absorb calcium. Other nutrients that promote bone health include protein, magnesium, vitamin K, and zinc.
To learn more about an eating plan that’s right for you, talk to your doctor. They can advise you on your diet, or refer you to a registered dietitian who can create a diet or meal plan for you. In the meantime, learn more about which nutrients you should focus on and those you should avoid, and take a look at a sample seven-day osteoporosis diet plan.
Eating right isn’t the only thing you can do to support the health of your bones. Exercise is very important as well, especially weight-bearing exercises.
Weight-bearing exercises are performed with either your feet or your arms fixed to the ground or another surface. Examples include:
- climbing stairs
training, such as:
- leg presses
training, such as working with:
- resistance bands
- resistance exercise machines
These exercises help because they cause your muscles to push and pull against your bones. This action tells your body to form new bone tissue, which strengthens your bones.
This isn’t your only benefit from exercise, however. In addition to its many positive effects on weight and heart health, exercise can also improve your balance and coordination, which can help you avoid falls.
Always check with your doctor before starting any new exercise program. Once they give you the go-ahead, try these eight bone-strengthening exercises that you can do at home.
There are many risk factors for osteoporosis that you cannot control. These include being female, getting older, and having a family history of osteoporosis. There are some factors, however, that do fall within your control.
Some of the best ways to prevent osteoporosis include:
- getting plenty of calcium and vitamin D
- doing weight-bearing exercises
- stopping smoking
- for women, weighing the pros and cons of hormone therapy
If you’re at risk of developing osteoporosis, talk to your doctor about the best way to prevent it. Also, check out this article about ways to maintain your bone health, as well as how to protect your bones by preventing falls.
If your doctor tells you that you have osteopenia, you may think you misheard the word "osteoporosis." However, osteopenia is a separate condition from osteoporosis.
Unlike osteoporosis, osteopenia is not a disease. Rather, it’s the state of having low bone density. With osteopenia, your bones aren’t as dense as normal, but they’re not as weakened as they are if you have osteoporosis.
The main risk factor for osteopenia is older age. Your bone density peaks at age 35, and after that, it can lessen as you get older.
In many cases, osteopenia can lead to osteoporosis, so if you have osteopenia, you should take steps to strengthen your bones. Find out more about osteopenia and ways to prevent it.
Osteoporosis is a disease that can have serious effects. It can lead to fractures, which can be painful, take a long time to heal, and lead to other complications. For instance, treatment for a hip fracture can include staying in bed for long periods, which raises your risk of blood clots, pneumonia, and other infections.
The good news is, there’s a lot you can do both to prevent and to treat osteoporosis, from eating right and exercising to taking appropriate medications. If you think you’re at risk of osteoporosis, or if you’ve been diagnosed with it, talk to your doctor. They can work with you to put together a prevention or treatment plan that can help improve your bone health and reduce your risk of complications from this common disease.
Written by: Debra Stang
Medically reviewed on Sep 12, 2017 by Gregory Minnis, DPT