Osteoporosis is a bone-weakening disease that most commonly occurs in older adults, but young people can get it, too. Doctors usually divide osteoporosis into two categories: idiopathic (unknown cause) and secondary (caused by a known condition).

Secondary osteoporosis in young people is most often caused by malnutrition, or not getting enough nutrients in your diet. It is also associated with chronic health conditions including asthma, diabetes, and epilepsy.

Identifying and treating juvenile osteoporosis is important to help a young person’s bones develop properly. We’ll overview potential causes and risk factors of this type of osteoporosis, and how treatment works.

Healthy bones are able to handle impact, bear weight, and be flexible. Osteoporosis affects a person’s bone density and mass, making them weaker and more prone to fractures.

Osteoporosis is generally called a “silent disease,” because many people don’t know they have it until they break a bone. The most common locations for fractures in osteoporosis are the hips, spine, and wrists. In younger people, this can include the ankles, and bones of arms and legs.

While bone formation for an adult skeleton is complete around age 25, your body is constantly building up and breaking down bone.

Osteoporosis is rare in children. That’s because childhood and the teenage years are when bones are typically growing their strongest. But because young people’s bones are still developing, osteoporosis can present differently than it does in adults. If untreated, juvenile osteoporosis can not only cause pain and injury, but have serious impacts on a young person’s physical development.

Juvenile osteoporosis is usually separated into one of two categories based on whether its cause can be identified or not. A 2022 study of 960 young people with osteoporosis found that 95.3 percent had secondary osteoporosis, while 4.7 percent had idiopathic osteoporosis.

Let’s overview how this categorization works.

Secondary osteoporosis is the result of another medical condition or behavior that causes bones to weaken.

According to the National Institutes of Health (NIH), medical conditions that can cause secondary osteoporosis include, among others:

Medications that can cause secondary osteoporosis include:

Overall, risk factors that can contribute to secondary osteoporosis in children include:

  • malnutrition
  • being underweight
  • anemia (low red blood cell count)
  • having another chronic health condition (especially asthma, diabetes, or epilepsy)
  • delayed puberty

Ideally, treating the underlying cause of secondary osteoporosis can help a young person build stronger bones.

Idiopathic juvenile osteoporosis (IJO) is when a young person has osteoporosis, but doctors can’t identify an underlying cause. In most children with this condition, the onset is around age 7. However, infants and teenagers can also experience idiopathic osteoporosis.

In most cases, IJO will initially cause symptoms in children that include pain in the lower back, hips, and feet. Children may start to experience problems walking or even break a bone or bones. Typically, IJO leads to metaphyseal and vertebral fractures. Metaphyseal injuries occur at the growing plates at the end of long bones. Vertebral fractures affect the joints of the spine.

Some people with IJO may have changes to their physical appearance, such as a curved spine or sunken chest. It’s unclear whether IJO directly causes these conditions.

Diagnosing juvenile arthritis involves taking a medical history and listening to a history of a children’s symptoms. Often, these descriptions may come from a caregiver who has observed changes in a child.

In addition to considerations for symptoms, a healthcare professional may also recommend imaging studies to determine how significant a young person’s bone loss may be.

Diagnostic imaging methods for osteoporosis are:

These test are usually more effective than an X-ray in helping a doctor identify bone loss. They are all painless and do not involve invasive techniques.

A doctor may perform other testing, such as blood testing, to rule out other potential causes. These include osteogenesis imperfecta, rickets, Wilson’s disease, or celiac disease.

If a secondary osteoporosis is occurring, a doctor will consider how to treat or adjust treatments to reduce a young person’s bone loss.

There are also lifestyle changes that can help a young person strengthen their bones and prevent injuries due to osteoporosis. These include:

  • going to physical therapy to strengthen muscles and increase flexibility
  • using assistive devices, such as crutches, to enhance mobility
  • increasing your intake of calcium and vitamin D to build stronger bones
  • maintaining a healthy weight, as being underweight is a risk factor

Sometimes, a doctor may prescribe medications commonly used to treat osteoporosis in adults. Known as bisphosphonates, these medications help reduce the rate the bones break down. However, doctors haven’t sufficiently studied these medications as treatment for juvenile osteoporosis.

Juvenile osteoporosis is rare, which makes study of it (with large groups of participants) more difficult.

Bones develop at a young age and typically reach their peak mass or strength at age 18 in females and 20 in males. Building strong bone mass at a young age is important to ensure a young person has healthy bone tissue for a lifetime.

Getting enough nutrients

Preventive methods include ensuring a child consumes enough calcium-containing foods. According to the NIH, here are the ideal calcium intakes for young people:

AgeCalcium needs (in milligrams)
1 to 3 years700
4 to 8 years1,000
9 to 18 years 1,300

Dairy-based products such as milk, yogurt, and cheese all contain calcium. However, there are nondairy options for calcium intake as well.

Calcium-rich foods include:

  • sardines (canned in oil, with bones)
  • tofu, firm, with added calcium
  • calcium-fortified orange juice
  • calcium-fortified cereal
  • turnip greens
  • kale
  • tortillas
  • broccoli

You may also wish to talk to your doctor about whether your child should take calcium or vitamin D supplements to build and maintain healthy bones.

Being active

Engaging in regular weight-bearing activity also helps kids build healthy bones. Examples of bone-building exercises can include walking, hiking, lifting weights, and dancing. (Swimming or bicycling, on the other hand, are not weight-bearing exercises.)

Physical activity for kids doesn’t necessarily have to be organized around a game or sport, and can look like going for a walk, or playing on a playground.

The World Health Organization recommends the following exercise guidelines by age groups:

Age groupRecommendation
1-2 years old180 minutes (3 hours) of physical activity throughout the day, any intensity. The WHO recommends you don’t restrain your baby in a carriage, high chair, or otherwise for more than 1 hour at a time.
3-4 years old180 minutes (3 hours) of physical activity throughout the day, and ideally have an hour of that time be moderate-to-vigorous intensity. Same recommendation regarding restraining as above.
5-17 years old60 minutes (1 hour) of physical activity per day, ideally moderate-to-vigorous intensity, and mostly aerobic. Additional vigorous aerobic exercise and exercise involving impact or weight bearing (to strengthen bone) should be incorporated at least 3 days a week.

Juvenile osteoporosis is a rare condition in children and teens that causes bone loss, increasing chance of fractures. It can lead to pain and affect young people’s structural development, sometimes leading to longterm skeletal irregularities.

This type of osteoporosis is categorized as “secondary,” as a result of another health condition or medication, or “idiopathic,” meaning of unknown cause. Prevention mostly consists getting good nutrition, enough physical activity, and managing other health conditions. Treatment can include physical therapy, medications, and nutritional supplements.

Receiving a timely diagnosis can help a child start a plan of care to strengthen their bones and prevent fractures. If your child has certain risk factors for juvenile osteoporosis, or is exhibiting symptoms, consider scheduling a screening.