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What is osteoporosis?

Wednesday, June 11, 2008


Osteoporosis is a disease that affects your bones. It means you have bones that are thin and brittle, with lots of holes inside them like a sponge. This makes them easy to break. Osteoporosis can lead to broken bones (fractures) in the hip, spine, and wrist. These fractures can be disabling and may make it hard for you to live on your own.

See a picture of healthy bone versus bone weakened by osteoporosis.

Osteoporosis affects millions of older adults. It usually strikes after age 60. It’s most common in women, but men can get it too.

What causes osteoporosis?

Osteoporosis is caused by a lack of bone strength or bone density. As you age, your bones get thinner naturally. But some things can make you more likely to have the severe bone thinning of osteoporosis. These things are called risk factors. Some risk factors you can change. Others you can't change.

Risk factors you can't change include:

Your age. Your risk for osteoporosis goes up as you get older.
Being a woman who has gone through menopause. After menopause, the body makes less estrogen. Estrogen protects the body from bone loss.
Your family background. Osteoporosis tends to run in families.
Having a slender body frame.
Your race. People of European and Asian background are most likely to get osteoporosis.
Risk factors you can change include:

Smoking.
Not getting enough exercise.
Drinking too much alcohol.
Not getting enough calcium, vitamin D, and phosphorus in the things you eat or from supplements.
To check your risk for osteoporosis, use this Interactive Tool: Are You At Risk for Osteoporosis?

What are the symptoms?
Osteoporosis can be very far along before you notice it. Sometimes the first sign is a broken bone in your hip, spine, or wrist after a bump or fall.

As the disease gets worse, you may have other signs, such as pain in your back. You might notice that you are not as tall as you used to be and that you have a curved backbone.

How is osteoporosis diagnosed?
Your doctor will ask about your symptoms and do a physical exam. You may also have a test that measures your bone thickness (bone density test) and your risk for a fracture.

If the test finds that your bone thickness is less than normal but is not osteoporosis, you may have osteopenia, a less severe type of bone thinning.

It’s important to find and treat osteoporosis early to prevent bone fractures. The United States Preventive Services Task Force advises routine bone density testing for women age 65 and older. If you have a higher risk for fractures, it’s best to start getting the test at age 60.

How is it treated?
Treatment for osteoporosis includes medicine to reduce bone loss and to build bone thickness. Medicine can also give you relief from pain caused by fractures or other changes to your bones.

It’s important to take both calcium and vitamin D supplements along with any medicine you take for the disease. You need both of these supplements to build strong, healthy bones.

You can slow osteoporosis with new, healthy habits. If you smoke, quit. Get plenty of exercise. Walking, jogging, dancing, and lifting weights can make your bones stronger. Eat a healthy mix of foods that include calcium and vitamin D. Try dark green vegetables, yogurt, and milk (for calcium). Eat eggs, fatty fish, and fortified cereal (for vitamin D).

Making even small changes in how you eat and exercise, along with taking medicine, can help prevent a broken bone.

When you have osteoporosis, it’s important to protect yourself from falling. Reduce your risk of breaking a bone by making your home safer. Make sure there’s enough light in your home. Remove throw rugs and clutter that you may trip over. Put sturdy handrails on stairs.

Frequently Asked Questions
Learning about osteoporosis:
What is osteoporosis?
What is osteopenia?
What causes osteoporosis?
What are the symptoms?
What happens when it develops?
What increases my risk for osteoporosis?
How can I check my risk for osteoporosis?
When should I call a doctor?
Are there different types of osteoporosis (classification)?
How common is it?
Can a test find osteoporosis early?

Being diagnosed:
How will my doctor diagnose osteoporosis?
What is a bone mineral density test?
Should I get a bone density test?

Getting treatment:
How is osteoporosis treated?
How can I prevent it?
Will I need to take medicine for osteoporosis?
Should I take bisphosphonate medicines for osteoporosis?
What lifestyle changes can I make to help reduce fractures?
Will hormone therapy reduce my risk for fractures?
Will I need surgery?
Are there other treatments for osteoporosis?

Living with osteoporosis:
Will weight-bearing exercises reduce my risk of fractures?
How can I get enough calcium to reduce my risk of fractures?


Author: Robin Parks, MS Medical Review: Joy Melnikow, MD, MPH - Family Medicine
Carla J. Herman, MD, MPH - Internal Medicine