Osteoporosis is a bone disease. Its name comes from the Latin for “porous bones.” The inside of a healthy bone has small spaces, like a honeycomb. Osteoporosis increases the size of these spaces, such that the bone loses strength and density. At the same time, the outside of the bone grows weaker and thinner.
People with osteoporosis are at a high risk of experiencing fractures while engaged in routine activities like standing or walking. About 53 million people either have osteoporosis or are at high risk of developing it. The most commonly affected bones are the wrists, hips, spine, and ribs.
There are no symptoms or warning signs of the early stages of osteoporosis. In most cases, people with osteoporosis are unaware that they have the condition until they experience a fracture.
Some spinal fractures may occur without initial pain. In these cases, the chief symptoms that a fracture has occurred may be loss of height or a bent spine.
The biggest risk factor for osteoporosis is age. As people grow older, the body goes through the process of breaking down old bone and growing new bone in its place. Around the age of 30, however, the body starts losing bone faster than it’s able to replace it.
Menopause can cause a woman’s body to lose bone even more quickly. Men continue to lose bone during this time, but at a slower rate. Between the ages of 65 and 70, women and men are usually losing bone at the same rate.
Other risk factors include:
- being female
- being an older adult
- being Caucasian or Asian
- family history/genetics
- poor nutrition
- physical inactivity
- taking certain medications
- low body weight
- small-boned frame
Osteoporosis is diagnosed with a painless bone density scan called a dual energy X-ray absorptiometry (DXA). It’s used to measure the density of the wrist, hips, and spine. These are the three areas most likely to experience osteoporosis.
A doctor may choose to run a DXA on people who are at high risk for developing osteoporosis. The doctor may also order a DXA to see if a fracture was caused by osteoporosis.
The most common drugs used to treat osteoporosis are called bisphosphonates. They include alendronate (Fosamax), Ibandronate (Boniva), and zoledronic acid (Reclast). Bisphosphonates are used to prevent the loss of bone mass. They may be taken orally or by injection.
The following treatments are also available:
In men, testosterone therapy may help increase bone density. 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.
One alternative medication, raloxifene (Evista), has been found to provide the benefits of estrogen without many of the risks, although there is still an increased risk of blood clots.
Other medications sometimes used in the treatment of osteoporosis include:
- denosumab (Xgeva or Prolia), which is taken by injection and may prove even more promising than bisphosphonates at reducing bone loss
- teriparatide (Forteo), which is also taken by injection and stimulates bone growth
- calcitonin salmon, which is taken as a nasal spray and reduces bone reabsorption, but needs to be used with caution because of its relationship to cancer
The chief complications of osteoporosis are fractures and the pain and disability that accompany them. Medication and lifestyle changes, such as fall prevention measures, can help you avoid fractures. Pain management and an appropriate plan for rehabilitation can ease the impact of fractures.
There are many risk factors for osteoporosis that you cannot control. These include sex, being 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
- engaging in weight-bearing exercises, such as walking or lifting weights
- stopping cigarette use
- for women, weighing the pros and cons of hormone therapy
Written by: Debra Stang
Published on Jul 19, 2017
Medically reviewed on Sep 12, 2017 by Gregory Minnis, DPT