What Is Osteoporosis?

Osteoporosis is a disease that causes loss of bone mass over time. This condition is called a "silent" disease because it doesn't cause pain or other obvious symptoms early on. However, as it progresses, osteoporosis can lead to bone fractures, which can be extremely painful.

This article discusses osteoporosis—what it is, what causes it to occur, how it's diagnosed, and its treatment options.

Close-up of provider reviewing x-ray image to patient on tablet computer

Cavan Images / Getty Images

Osteoporosis Symptoms

In its early stages, osteoporosis doesn't typically cause pain or other physical symptoms; however, severe osteoporosis can lead to bone fractures that are painful. These fractures often happen after a fall or with simple daily tasks, like getting out of bed or bumping into furniture.

Fractures from osteoporosis typically affect the spine, hips, or wrists. In addition to severe pain, fractures in the spine can cause decreased height and a bent-over posture. As the disease progresses, osteoporosis can also cause changes in the way you walk and impact your balance.

Fractures From Osteoporosis

Approximately 1 in 2 women and 1 in 4 men with osteoporosis will experience bone fractures.

What Causes Osteoporosis?

Bone tissue is constantly breaking down and rebuilding itself through a process called remodeling. Osteoporosis develops when bone breaks down faster than it builds back up.

Risk Factors for Osteoporosis

Various factors can increase your risk of developing osteoporosis, including:

  • Assigned female at birth
  • Older age
  • Thinner bones (people with a more petite build)
  • Too much thyroid hormone
  • Too little estrogen in females
  • Too little testosterone in males
  • A diet that is low in protein, vitamin D, or calcium
  • White or Asian descent
  • Heavy consumption of alcohol
  • Long-term use of steroid medication, antiepileptic drugs, and possibly proton pump inhibitors
  • Smoking
  • Long periods of bed rest
  • Family history of osteoporosis
  • Menopause

How Is Osteoporosis Diagnosed?

In many people, osteoporosis isn't diagnosed until they've experienced a bone fracture. However, a healthcare provider may recommend screening via bone mineral density testing to identify osteoporosis or osteopenia (a precursor to osteoporosis).

Healthcare providers commonly use central dual-energy X-ray absorptiometry (DEXA scan) to test bone mineral density. Bones in the hip and spine are typically scanned, and results are given as a T-score. Here is what T-score results mean:

  • A normal T-score is between plus 1 (+1) and negative 1 (-1)
  • Low bone mass is represented by a T-score between -1 and -2.5
  • A score that is lower than -2.5 indicates osteoporosis.

Fragility fractures (broken bones from low-impact trauma) that occur from osteoporosis are diagnosed with imaging tests, such as:

Osteopenia vs. Osteoporosis

Osteopenia is a condition caused by less than average bone mass, but not to the point that the bone can be easily fractured. It is similar to osteoporosis in that it affects bone mineral density. Osteopenia is less severe than osteoporosis but should be taken seriously since it can progress to osteoporosis. If you have osteopenia, a healthcare provider will probably recommend bone density testing every two to five years.

Who Should Get Screened for Osteoporosis?

Osteoporosis screening is often recommended for woman over age 65 or for people with risk factors for this condition.

How Is Osteoporosis Treated?

Treatment for osteoporosis focuses on stopping (or slowing) bone loss and reducing the risk of bone fractures. Treatment can include:

However, osteoporosis cannot be fully reversed.

Osteoporosis Medications

Medications for osteoporosis can either slow bone loss or help rebuild bone.

Bisphosphonates are often used first to treat bone loss. These can include:

  • Fosamax (alendronate)
  • Boniva (ibandronate)
  • Actonel, Atelvia (risedronate)
  • Reclast (zoledronic acid)

Other osteoporosis medications include:

  • Prolia (denosumab)
  • Evenity (romosozumab)
  • Evista (raloxifene)
  • Forteo (teriparatide)
  • Tymlos (abaloparatide)

Physical Therapy

Physical therapy exercises address many issues that occur with osteoporosis—decreased balance, posture changes, decreased flexibility, and risk of fractures.

Examples include:

A physical therapist can also determine whether you need an assistive device (such as a cane or walker) to improve safety with walking.

Perhaps most importantly, a physical therapist can teach you which exercises to avoid—specific movements, such as twisting your spine—can increase your risk of fractures when you have osteoporosis.

Lifestyle Behaviors

Simple changes in your lifestyle, including the following, can improve your overall bone health if you have osteoporosis:

  • Avoid (or quit) smoking.
  • Limit alcohol consumption.
  • Eat adequate amounts of foods high in protein.
  • Consider taking calcium or vitamin D supplements (if recommended by your healthcare provider).
  • See your healthcare provider regularly.

How to Prevent Osteoporosis

Staying active and eating a diet that includes adequate protein, calcium, and vitamin D can help maintain healthy bones early in life, which could ultimately help increase bone density and prevent osteoporosis.

Talk to a healthcare provider about screening for osteoporosis—particularly if you have risk factors for this condition. Early detection and treatment can help slow bone loss and reduce the risk of fractures.

Ways to Prevent Osteoporosis Fractures

While you can't always prevent osteoporosis, there are things you can do to reduce the risk of fractures if you've been diagnosed with this condition.

In addition to medications and exercise, consider these steps to improve safety at home and reduce the risk of falls, which can lead to fractures:

  • Remove throw rugs.
  • Keep walkways clear of clutter.
  • Install grab bars in the shower and next to the toilet.
  • Wear shoes with nonslip soles (even inside).
  • Install handrails in stairways.
  • Place night-lights in rooms and hallways.
  • Use a shower chair.
  • Keep your cell phone within reach.

Outlook for Osteoporosis: Support and Resources

Living with osteoporosis can significantly impact your quality of life. Consider joining a support group, such as the Online Osteoporosis Community through American Bone Health, to connect with others with the same condition. Additional resources for living well with osteoporosis can be found online through the Bone Health & Osteoporosis Foundation.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Osteoporosis basics.

  2. Johns Hopkins Medicine. Osteoporosis.

  3. National Institute on Aging. Osteoporosis.

  4. NIH Osteoporosis and Related Bone Diseases National Resource Center. Bone mass measurement: what the numbers mean.

  5. Harvard Health Publishing. Osteopenia: When you have weak bones but not osteoporosis.

  6. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Osteoporosis basics: diagnosis, treatment, and steps to take.

  7. Harvard Health Publishing. Osteoporosis drugs: which one is right for you?

  8. Johns Hopkins Medicine. What you can do now to prevent osteoporosis.

By Aubrey Bailey, PT, DPT, CHT
Aubrey Bailey is a physical therapist and professor of anatomy and physiology with over a decade of experience providing in-person and online education for medical personnel and the general public, specializing in the areas of orthopedic injury, neurologic diseases, developmental disorders, and healthy living.