Osteoporosis: Prognosis, Complications, and Treatment

Osteoporosis causes progressive bone loss that can lead to fractures, breaks, and deformities. While the condition worsens over time, proper treatment can help reduce complications and alleviate symptoms.

This article discusses the prognosis, complications, and treatment options associated with osteoporosis.

A healthcare provider showing an older woman an X-ray

milorad kravic / Getty Images

Stages of Osteoporosis

There are four stages of osteoporosis. Each is categorized by the rate at which the bone loss occurs in relation to bone formation and a T-score, which is a bone density score used to diagnose osteoporosis.

Stages of Osteoporosis
Stage Age  Rate of Bone Growth and Breakdown Symptoms T-Score
1 Early 20s to 30s Equal pace No symptoms +1 to -1
2 Begins between 25 and 35  Bone loss begins to outpace bone rebuilding No symptoms -1 to -2.5
3 Begins between 45 and 55 Bone loss outpaces bone rebuilding Symptoms may remain unnoticeable but the risk of fractures and breaks is increased -2.5 or lower 
4 Anytime after 45 Significant bone loss with a severe reduction or no bone growth Risk of fractures and breaks is high and symptoms begin to develop such as a spinal curve from soft and weak spinal bones Well below -2.5

Osteoporosis Prognosis

People living with osteoporosis experience a reduced quality of life and lower life expectancy rates. The length of time a person can live with osteoporosis depends on their treatment and the age when they were diagnosed.

Life Expectancy Rates by Sex and Age
Age Treatment Begins Males  Females  
50 years old 18.2 years 26.4 years
75 years old 7.5 years  13.5 years 

What Is the Average Life Expectancy for People With Osteoporosis?

When looking at the average, research has shown that males who begin treatment before 60 and women who begin treatment before 75 can expect to live 15 years or more following their diagnosis.

The Importance of Early Detection

Because osteoporosis is progressive, detecting it early is vital. In addition, the treatments in place for the condition can both slow bone loss and help rebuild new bone, so if a person is diagnosed early and follows a treatment plan, they can better avoid disease complications, such as bone fractures.

Preventing Osteoporosis

If a person stays on top of their bone health early on in life, they can prevent significant bone loss from occurring. By doing so, they can reduce their risk of developing osteoporosis.

Common Complications

Several osteoporosis-related complications can significantly reduce a person’s quality of life and cause a shortened life expectancy. Those complications include:

  • Fractures: Roughly 8.9 million fractures are caused by osteoporosis each year. That amounts to one fracture every three seconds.
  • Pain: Chronic pain isn’t directly caused by osteoporosis, but it can develop after fractures. One specific complication is kyphosis, which causes pain from muscle, tendon, and ligament strain in the back.
  • Posture changes: As mentioned above, kyphosis can occur in people with osteoporosis after fractures occur in the spine. The complication causes the spine to round forward, leading to a hunched-over appearance or a pushed-out stomach. Kyphosis can cause further complications, such as difficulty breathing and eating, caused by the body bending in an unnatural position.
  • Limited mobility: Fractures and temporary immobility caused by fractures can lead to long periods of physical inactivity. Eventually, this inactivity further weakens muscles and other parts of the body.

Avoiding Complications

The best way to avoid complications if you already have osteoporosis is by following through with a treatment plan that includes lifestyle changes and medications.

Treatment

Treating osteoporosis focuses on reducing bone loss and building new bone tissue. Medications and lifestyle interventions should be used together during treatment for the best results.

Medications

Medications used to treat osteoporosis do so by affecting different bodily processes that cause bone loss. Drugs used to treat the condition include:

Medication Type What it Does  How it Works
Bisphosphonates Works on both rebuilding bones and preventing bone loss Osteoclasts absorb the medication instead of old bone tissue, slowing down bone breakdown.
Hormone-related medications Act as vital hormones in the body Work by reducing bone loss caused by hormone deficiencies or ensuring there are enough hormones needed for adequate nutrient absorption
Hormone-replacement Therapy Ensures the body has enough estrogen for bone remodeling Increases estrogen levels
Antibody drugs Stabilizes cell signaling pathways that aid in bone remodeling Regulates the action and production of osteoclasts and osteoblasts

What are Osteoclasts and Osteoblasts?

Osteoclasts are cells that break down bones, and osteoblasts are cells that help form new bone tissue.

Lifestyle

Making lifestyle changes can also help with osteoporosis because certain factors play a role in the development and progression of the disease. For example, to improve osteoporosis to avoid complications, you can:

  • Exercise: Exercise, especially weight-bearing and resistance exercises, can help to strengthen the bones by encouraging the action of osteoblasts.
  • Eat healthily: Vitamin D and calcium deficiencies can speed up bone loss. By getting enough of these in your diet, you can ensure that you give your body what it needs for an adequate bone remodeling cycle.
  • Quit smoking: Smoking can cause bone loss for many reasons, including inhibiting nutrient absorption, causing inflammation, and driving an imbalance in important hormones.
  • Avoid alcohol: Heavy alcohol use has been shown to increase stress hormones, hinder nutrient absorption, and cause hormone imbalance, all of which can increase bone loss.

Making Lifestyle Changes and Sticking to Them

While lifestyle changes won’t cure or reverse osteoporosis, alongside effective medication, they can significantly reduce your risk of complications and improve your quality of life. For example, if you have difficulty quitting smoking or reducing your alcohol intake, you can contact Quitlines for smoking or the National Institute on Alcohol Abuse and Alcoholism for help.

Living With Osteoporosis

Managing osteoporosis effectively is vital for maintaining a good quality of life with the condition. One of the most important aspects of coping with the disease is preventing fractures since a break can lead to other complications and worsened outcomes.

Aside from taking your medications as prescribed and sticking to your lifestyle changes, you can:

  • Use a cane or walking aid to help stabilize yourself while walking
  • Choose footwear that has a grip sole and adequate foot and body support
  • When in doubt, walk on the grass to avoid slippery pavement
  • Avoid winter falls by icing sidewalks around your home
  • Always check the height of a curb or step before going ahead
  • Clear a path within your home free of debris or cords
  • Install carpet or plastic floor runners on hard and possibly slippery floors
  • Wear indoor shoes that provide support
  • Install railings on the sides of all staircases
  • Install bars in your bath or shower and near your toilet
  • Use a rubber bathmat inside your tub or shower
  • Install a shower seat
  • Keep a cell phone on you so you are close by if someone calls and won’t need to rush to answer it
  • Explore personal emergency response systems to have on you at all times in case of a fall

You could also explore osteoporosis support groups to get more tips on managing your disease from people who genuinely know what you’re going through.

How Many People Have Osteoporosis?

Osteoporosis is quite common, especially in aging populations. Roughly 10 million people in the U.S. have the condition, while 44 million are at risk of developing it.

Summary

Osteoporosis is a progressive condition. While it is not considered fatal in and of itself, it does shorten a person’s life expectancy. That is especially true if someone does not receive adequate treatment. However, people with osteoporosis can expect to live 15 years or more after their diagnosis if they take the proper medications and make the necessary lifestyle changes.

Treatments for osteoporosis are designed to lessen bone loss and aid in forming new bone so that bone mass can be somewhat restored to reduce the risk of fractures and complications. During treatment, people with the condition should pay attention to their homes and surroundings to ensure that they take all the necessary steps to avoid a fall that could lead to a bone break or fracture.

Frequently Asked Questions

  • Can osteoporosis be cured?

    There is no cure for osteoporosis, and it cannot be fully reversed. However, viable treatments are available that help prevent bone loss and slow the progression of the disease. People with proper treatment can expect a maintained quality of life while managing the disease.

  • What is the prognosis for osteoporosis if it’s left untreated?

    Osteoporosis affects lifespan. However, people with the condition are only affected if they experience fractures or severe bone loss that causes kyphosis. Fractures cause complications that can lead to a decreased quality of life and early mortality. People who do not treat their osteoporosis are much more likely to experience fractures that could lead to death. While it’s not clear how long a person can live with the disease without treatment, it does put you at serious risk of a lowered life expectancy.

  • How quickly does osteoporosis progress?

    Bone loss begins in a person’s late 20s and early 30s. After that, the rate at which bone loss occurs differs depending on the person and other lifestyle factors. For example, people going through menopause may lose bone at a rate of 4% per year. 

14 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 Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center. Bone mass measurement: what the numbers mean.

  2. Abrahamsen B, Osmond C, Cooper C. Life expectancy in patients treated for osteoporosis: observational cohort study using national Danish prescription data. J Bone Miner Res. 2015;30(9):1553-1559. doi:10.1002/jbmr.2478

  3. Rinaldi C, Bortoluzzi S, Airoldi C, et al. The early detection of osteoporosis in a cohort of healthcare workers: is there room for a screening program? Int J Environ Res Public Health. 2021;18(3):1368. doi:10.3390/ijerph18031368

  4. International Osteoporosis Foundation. Epidemiology of osteoporosis and fragility fractures.

  5. Bone Health and Osteoporosis Foundation. Osteoporosis and your spine.

  6. National Institutes on Health Osteoporosis and Related Bone Diseases National Resource Center. Bed rest and immobilization: risk factors for bone loss.

  7. Maraka S, Kennel KA. Bisphosphonates for the prevention and treatment of osteoporosisBMJ. 2015:h3783. doi:10.1136/bmj.h3783

  8. Benedetti MG, Furlini G, Zati A, Letizia Mauro G. The effectiveness of physical exercise on bone density in osteoporotic patients. Biomed Res Int. 2018;2018:4840531. doi:10.1155/2018/4840531

  9. Muñoz-Garach A, García-Fontana B, Muñoz-Torres M. Nutrients and dietary patterns related to osteoporosis. Nutrients. 2020;12(7):1986. doi:10.3390/nu12071986

  10. Al-Bashaireh AM, Haddad LG, Weaver M, Chengguo X, Kelly DL, Yoon S. The effect of tobacco smoking on bone mass: an overview of pathophysiologic mechanisms. J Osteoporos. 2018;2018:1206235. doi:10.1155/2018/1206235

  11. Cheraghi Z, Doosti-Irani A, Almasi-Hashiani A, et al. The effect of alcohol on osteoporosis: a systematic review and meta-analysis. Drug Alcohol Depend. 2019;197:197-202. doi:10.1016/j.drugalcdep.2019.01.025

  12. National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center. Osteoporosis overview.

  13. National Osteoporosis Foundation. Osteoporosis fast facts.

  14. Johns Hopkins Arthritis Center. Osteoporosis information.

By Angelica Bottaro
Angelica Bottaro is a professional freelance writer with over 5 years of experience. She has been educated in both psychology and journalism, and her dual education has given her the research and writing skills needed to deliver sound and engaging content in the health space.