What is osteoporosis?
Osteoporosis is a condition that affects the bones. 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.
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.
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.
Back or neck pain or loss of height 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.
To understand osteoporosis, it can help to see what normal bone looks like versus bone affected by osteoporosis.
The biggest risk factor of osteoporosis is age. Throughout your life, your body breaks down old bone and grows new bone.
However, when you’re in your 30s, your body starts breaking down bone faster than it’s able to replace it. This leads to bone that’s less dense and more fragile, and thus more prone to breakage.
Menopause is another primary risk factor, 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.
Other risk factors for osteoporosis include:
- being female
- being Caucasian or Asian
- having a family history of osteoporosis
- poor nutrition
- physical inactivity
- low body weight
- small-boned frame
You can control some of these risk factors for osteoporosis, such as poor nutrition and inactivity. For instance, you can improve your diet and start an exercise program can benefit your bone health. However, you can’t control other risk factors, such as your age or gender.
You may have heard of senile osteoporosis. This isn’t a separate type — it’s simply osteoporosis that’s caused by aging when other possible secondary causes are excluded.
As mentioned above, age is a primary risk factor 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.
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.
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:
- alendronate (Fosamax)
- ibandronate (Boniva)
- risedronate (Actonel)
- zoledronic acid (Reclast)
Other medications may be used to prevent bone loss or stimulate bone growth. They include:
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.
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.
This drug is taken by injection and may prove even more promising than bisphosphonates at reducing bone loss.
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.
This medication was approved by the FDA in April of 2019 to treat women who have gone through menopause and are at a high risk of having fractures.
The drug is given in two injections under the skin (in the same sitting) once a month for 12 months or less. It has a “black box” warning because the Evenity may increase the risk of heart attacks or strokes, so it’s not recommended for people with a history of either.
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. 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.
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.
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.
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
- resistance training, such as:
- leg presses
- weight 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.
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 recommended daily amount 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.
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.
Osteoporosis is a condition 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.
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.