What is osteoporosis?
Osteoporosis is a disease that causes bones to become weak and brittle. This increases your risk of broken bones (fractures).
Osteoporosis is a “silent” disease because you may not have symptoms. You may not even know you have the disease until you break a bone. Breaks can occur in any bone but happen most often in:
- Hip bones.
- Vertebrae in the spine.
You can take steps to help prevent osteoporosis and broken bones by:
- Doing weight-bearing exercises, such as walking or dancing, and lifting weights.
- Not drinking too much alcohol.
- Quitting smoking, or not starting if you don’t smoke.
- Taking your medications, if prescribed.
- Eating a well-balanced diet rich in calcium and vitamin D.
Who gets osteoporosis?
Osteoporosis affects women and men of all races and ethnic groups. Osteoporosis can occur at any age, although you are at greater risk as you get older. For many women, the disease begins to develop a year or two before menopause.
- Osteoporosis is most common in non-Hispanic white women and Asian women.
- African American and Hispanic women have a lower risk of developing osteoporosis, but they are still at significant risk.
- Among men, osteoporosis is more common in non-Hispanic whites.
Because women get osteoporosis more than men, many men think they won’t get the disease. But older men and women are at risk for the disease.
What are the symptoms of osteoporosis?
Osteoporosis is called a “silent” disease” because you typically have no symptoms until a bone breaks or one or more vertebrae in the spine collapse. Symptoms of broken vertebrae include severe back pain, loss of height, or a stooped or hunched posture.
Bones affected by osteoporosis may break very easily or as the result of:
- Minor falls that would not normally cause a break in a healthy bone.
- Normal stresses such as bending, lifting, or even coughing.
What causes osteoporosis?
Osteoporosis happens when new bone tissue is not made as fast as old bone tissue is lost. When this happens, too much bone is lost and the bones become weak.
Certain factors may make you more at risk of developing the disease. There are some factors that you cannot change, and others that you may be able to change. Factors that may increase your risk for osteoporosis include:
- Sex. If you are a woman, you are at greater risk for developing osteoporosis. However, men are still at risk, especially after the age of 70.
- Age. As you age, your bones can get weaker.
- Body size. Slender, thin-boned women and men are at greater risk to develop osteoporosis.
- Race. White and Asian women are at highest risk. African American and Mexican American women have a lower risk.
- Family history. Your risk for osteoporosis and broken bones may increase if one of your parents has a history of osteoporosis or hip fracture.
- Changes to hormones. Low levels of certain hormones can increase your chances of developing osteoporosis.
- Diet. A diet low in calcium and vitamin D can increase your risk for osteoporosis and broken bones. Dieting too much or getting too little protein may also increase your risk for bone loss and osteoporosis.
- Other medical conditions. Some medical conditions can increase the risk of osteoporosis.
- Medications. Long-term use of certain medications may make you more likely to develop bone loss and osteoporosis.
- Lifestyle. A healthy lifestyle can be important for keeping bones strong. Lifestyle changes that may cause bone loss include:
- Not getting enough exercise and being inactive for long periods of time.
- Long-term heavy drinking of alcohol.
Is there a test for osteoporosis?
If you are a woman over age 65 or if you are a woman of any age who has factors that increase the chance of developing osteoporosis, your doctor likely will screen you for osteoporosis.
Younger women and older men should talk to their doctor to find out if they have risk factors for osteoporosis.
During your visit with your doctor, remember to talk about:
- Any broken bones you have had.
- Your diet, exercise, alcohol use, and smoking history.
- Current or past medical conditions and medications that could lead to low bone mass and increased risk of broken bones.
- Your family history of osteoporosis and other diseases.
- For women, your menstrual history.
The doctor may also perform a physical exam that includes checking for:
- Loss of height and weight.
- Changes in posture.
- Balance and the way you walk.
- How strong your muscles are, such as if you can stand from sitting without using your arms.
In addition, your doctor may order a test that measures your bone mineral density in an area of your bone. This test measures how much calcium and other minerals are in a specific area of your bone, usually your spine and hip.
How is osteoporosis treated?
The goals for treating osteoporosis are to slow or stop bone loss and to prevent broken bones. Your doctor may recommend:
- Eating a healthy diet.
- Making healthy choices about smoking and alcohol.
- Working to prevent falls to help prevent fractures.
- Taking medications.
If you develop osteoporosis from another condition, work with your doctor to treat the underlying cause.
An important part of treating osteoporosis is eating a healthy, balanced diet, which includes:
- Plenty of fruits and vegetables.
- An appropriate amount of calories for your age, height, and weight. Talk to your doctor about the amount of calories you need each day to keep a healthy weight.
- Foods and liquids that include calcium, vitamin D, and protein. Good sources of calcium include:
- Low-fat dairy products.
- Dark green leafy vegetables, such as bok choy, collards, and turnip greens.
- Sardines and salmon with bones.
- Calcium-fortified foods such as soymilk, tofu, orange juice, cereals, and breads.
Vitamin D helps your body absorb calcium. Some foods naturally contain enough vitamin D, including fatty fish, fish oils, egg yolks, and liver. Other foods have added vitamin D, including milk and cereals.
You can make some choices to keep your bones healthy:
- Avoid secondhand smoke, and if you smoke, quit.
- If you drink alcohol, only have one drink a day if you’re a woman and two drinks a day if you’re a man.
- Visit your doctor for regular checkups and ask about anything that may affect your bone health or increase your chance of falling, such as medications or other medical conditions.
Exercise is an important part of an osteoporosis treatment program. During childhood and adulthood, exercises such as walking, dancing, or weight lifting can make bones stronger. For older adults, regular exercise can help:
- Keep muscles strong and improve coordination and balance. This can help lower your chance of falling.
- Keep your independence.
- Manage your daily living tasks.
If you have osteoporosis, you should not do high-impact exercise. Work with a physical therapist or rehabilitation medicine specialist to figure out an exercise program that works for you.
Your doctor may prescribe medications for osteoporosis. Your doctor will discuss the best option for you, thinking about your age, sex, general health, and the amount of bone you have lost.
Who treats osteoporosis?
Health care providers who treat osteoporosis include:
- Endocrinologists, who treat problems related to the glands and hormones.
- Geriatricians, who specialize in caring for all aspects of health in older people.
- Gynecologists, who specialize in diagnosing and treating conditions of the reproductive system of women.
- Nurse educators, who specialize in helping people understand their overall condition and set up their treatment plans.
- Occupational therapists, who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.
- Orthopaedists, who specialize in the treatment of and surgery for bone and joint diseases or injuries.
- Physiatrists (doctors specializing in physical medicine and rehabilitation).
- Physical therapists, who help to improve joint function.
- Primary care providers, such as a family physician or internal medicine specialist.
- Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles.
Living with osteoporosis
In addition to the treatments your doctor recommends, the following tips can help you manage osteoporosis, prevent broken bones, and prevent falls.
Broken bones can cause other medical problems and take away your independence. Falls increase your chances of breaking a bone in the hip, wrist, spine, or other bone. Taking steps to prevent falls both inside and outside of the house can help prevent broken bones. It is important to tell your doctor if you have had problems with falling.
Here are some tips to help prevent falls outdoors and when you are away from home:
- Use a cane or walker to keep you stable and provide support.
- Wear shoes that provide support and have thin nonslip soles.
- Walk on grass when sidewalks are slippery.
- Stop at curbs and check their height before stepping up or down.
Some ways to help prevent falls indoors are:
- Keep rooms free of clutter, especially on floors.
- Use plastic or carpet runners on slippery floors.
- Wear shoes, even when indoors.
- If you have a pet, be aware of where they are to avoid tripping over them.
- Do not walk in socks, stockings, or slippers.
- Be careful on highly polished floors that are slick.
- Be sure carpets and area rugs have skid-proof backing or are tacked to the floor.
- Be sure stairs are well lit and have rails on both sides.
- Install grab bars on bathroom walls near the tub, shower, and toilet.
- Use a rubber bathmat or slip-proof seat in the shower or tub.
- Keep your home well lit, and use a nightlight.
- Use a sturdy stepstool with a handrail and wide steps.
- Keep a cordless phone or cell phone with you.
- Consider having a personal emergency-response system; you can use it to call for help if you fall.
Other tips that can help you manage your osteoporosis include:
- Talking with other people who have osteoporosis.
- Reaching out to family and friends for support.
- Learning about the disease and treatments to help you make decisions about your care.