Osteoporosis

Osteoporosis is a common condition impacting approximately 10 million Americans that is the result of decreased bone mass and changes in bone structure, thereby increasing the risk of a bone fracture. Osteoporosis is more common in women after menopause and is a condition typically treated by primary care doctors, endocrinologists, and rheumatologists. Risk factors for osteoporosis include: advancing age, non-Hispanic white or Asian background, low weight, having parents who suffered a fracture, having a previous fracture, and smoking. Alcohol abuse, sedentary lifestyle, and low levels of vitamin D are other risk factors. Osteoporosis can be a side effect of some medications, such as glucocorticoids, heparin, and certain cancer treatments.

What Are the Signs/Symptoms?

Osteoporosis does not have noticeable symptoms. Most people discover they have osteoporosis after a bone breaks, even from a minor injury like a fall. Osteoporosis fractures are most common in the spine, hip, and wrist. They may lead to chronic pain, disability or even death in some cases. If you have risk factors for osteoporosis, your doctor can order a bone mineral density (BMD) test to assess your bone health. A T-score of -2.5 or lower indicates osteoporosis. People with T-scores between -1.0 and -2.5 have low bone mass or osteopenia and may still require treatment depending on other risk factors.

What Are Common Treatments?

People with osteoporosis should get enough calcium and vitamin D in their diet or supplements to support healthy bone mass. They should participate in regular physical activity, including weight-bearing exercises like walking. Most people with osteoporosis also need medications to slow bone mass loss or prevent fractures. Bisphosphonates are the most common treatments for osteoporosis. These anti-resorptive drugs include alendronate, risendronate, ibandronate, and zoledronic acid. Side effects of bisphosphonates are rare but can include osteonecrosis of the jaw and atypical femoral fractures. Other osteoporosis treatments include denosumab, teriparatide, and abaloparatide.

Living with Osteoporosis

People with osteoporosis should take action to prevent slips or falls that could cause a bone fracture such as using a cane or walker, removing tripping hazards such as throw rugs, and installing handrails in the shower can be recommended. Wearing proper shoes and avoiding heavy lifting and using nightlights to prevent falls are also helpful. Exercises like yoga and tai chi help improve balance to prevent slips and falls. Osteoporosis may be preventable with proper intake of calcium and vitamin D, smoking avoidance, and regular physical activity.

Updated February 2023 by Bhakti Shah, MD, and reviewed by the American College of Rheumatology Committee on Communications and Marketing.

This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.