Osteoporosis is a disease marked by decreasing bone mass, density, and quality, making bones weak and brittle. If left unchecked, it can lead to
fractures. Any bone can be affected. Fractures of special concern are of the
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Osteoporosis is caused by an imbalance between bone loss and bone formation (known as bone remodeling). After age 30, bone loss occurs more quickly. Many factors over the course of a lifetime can influence bone remodeling.
Osteoporosis is more common in older adults. It is more common in women than in men. People of Caucasian, Asian, or Hispanic ethnicity are more likely to get osteoporosis.
Osteoporosis is more likely to occur if full bone mass was not achieved during your bone-building years. Other factors that may increase your chance of osteoporosis include: Low weightSmokingAlcohol abuseHistory of fallsFamily history of osteoporosisPostmenopausal status
Certain health conditions, such as:
No menstrual periods—
amenorrheaHyperthyroidismType 2 diabetesAsthmaLiver diseaseEating disorderDepressionCrohn's diseaseCeliac diseaseFemale athlete triad Certain medications, such as antidepressants, corticosteroids, anticonvulsants, or long-term use of heparin or proton-pump inhibitorsLow hormone levels (low estrogen levels in women, low testosterone levels in men)Inactive lifestyle
Certain restrictive diets that may result in a deficit of
vitamin DToo little sunlight—the effect of sun on the skin is a primary source of vitamin D
Certain cancers, including
In most cases, people with osteoporosis remain symptom-free until there is a fracture. In those who do have symptoms, osteoporosis may cause: Severe back pain
Loss of height with stooped posture (kyphosis}
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You will be asked about your symptoms and medical history. A physical exam will be done. Tests may include: Blood testsUrine tests
The density level of your bones may be tested. This can be done with: Dual-energy x-ray absorptiometry
Quantitative ultrasound (QUS)Quantitative CT scan (QCT)
The treatment and management of osteoporosis involves lifestyle changes and medications. Although osteoporosis is highly preventable, it cannot be cured. Treatment focuses on reducing the incidence of fractures and slowing bone loss.
Decrease your intake of
alcohol. Eat a balanced diet rich in calcium and vitamin D. Calcium is in: Dairy productsGreen leafy vegetablesCanned fish with bonesCalcium-fortified products
Do not smoke.
If you smoke,
talk with your doctor about ways you can successfully
Exercise improves bone health. It also increases muscle strength, coordination, and balance. Do weight-bearing and strength-training exercises for maximum benefit. Balance training may
prevent falls and fractures.
People who do not eat enough calcium from food might want to take calcium supplements.
Vitamin D and other supplements may also be advised.
Talk with your doctor before
taking herbs or supplements.
Falls can increase the chance of fracture in someone with osteoporosis. Here are ways to prevent falls: Floors—Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its usual place.Bathrooms—Install grab bars and non-skid tape in the tub or shower.Lighting—Make sure halls, stairways, and entrances are well lit. Install a night light in your bathroom. Turn lights on if you get up in the middle of the night.Kitchen—Install non-skid rubber mats near sink and stove. Clean spills right away.Stairs—Make sure treads, rails, and rugs are secure.Other precautions—Wear sturdy, rubber-soled shoes. Keep your intake of alcoholic beverages to a minimum. Ask your doctor whether any of your medications might cause you to fall.
Certain medications can help prevent bone loss, increase bone density, and reduce your risk of fractures. These may include: Bisphosphonates to prevent the loss of boneParathyroid hormone therapy to stimulate bone growthSelective estrogen receptor modulators to prevent bone loss, improve density, and decrease fractures
Building strong bones throughout your early years is the best defense against osteoporosis. Getting enough calcium,
and regular exercise can keep bones strong throughout life.
To help reduce your chance of osteoporosis: Eat a balanced diet rich in calcium and vitamin D.Perform weight-bearing exercises.Live a healthy lifestyle—avoid smoking and drink alcohol only in moderation (2 drinks per day for men, 1 drink per day for women).If you are a postmenopausal woman at high risk for bone fractures, medications may be appropriate to prevent osteoporosis.
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https://www.nof.org/prevention/. Updated 2013. Accessed May 11, 2016.
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Making a diagnosis. National Osteoporosis Foundation website. Available at:
http://nof.org/articles/8. Accessed May 11, 2016.
Osteoporosis tests. American Academy of Orthopedic Surgeons
Ortho Info website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=A00413. Updated August 2007. Accessed May 19, 2016.
Sambrook P, Cooper C. Osteoporosis.
10/6/2006 DynaMed Plus Systematic Literature Surveillance
http://www.dynamed.com/topics/dmp~AN~T113815/Osteoporosis: Cockayne S, Adamson J, Lanham-New S, et al. Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials.
Arch Intern Med. 2006;166:1256-1261.
5/16/2008 DynaMed Plus Systematic Literature Surveillance
http://www.dynamed.com/topics/dmp~AN~T113815/Osteoporosis: Qaseem A, Snow V, Shekelle P, Hopkins R Jr, Forciea MA, Owens DK; Clinical Efficacy Assessment Subcommittee of the American College of Physicians. Screening for osteoporosis in men: a clinical practice guideline from the American College of Physicians.
Ann Intern Med. 2008;148:680-684.
12/29/2009 DynaMed Plus Systematic Literature Surveillance
http://www.dynamed.com/topics/dmp~AN~T113815/Osteoporosis: Hippisley-Cox J, Coupland C. Predicting risk of osteoporotic fracture in men and women in England and Wales: prospective derivation and validation of QFractureScores.
6/4/2010 DynaMed Plus Systematic Literature Surveillance
http://www.dynamed.com/topics/dmp~AN~T113815/Osteoporosis: FDA approves new injectable osteoporosis treatment for postmenopausal women. US Food and Drug Administration website. Available at:
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm214150.htm. Published June 1, 2010. Accessed June 4, 2015.
Last reviewed June 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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