Orthopedics Osteoporosis Who Treats Osteoporosis? By Tim Petrie, DPT, OCS Tim Petrie, DPT, OCS LinkedIn Tim Petrie, DPT, OCS, is a board-certified orthopedic specialist who has practiced as a physical therapist for more than a decade. Learn about our editorial process Published on February 28, 2023 Medically reviewed by David Ozeri, MD Medically reviewed by David Ozeri, MD LinkedIn David Ozeri, MD, is a board-certified rheumatologist from Tel Aviv, Israel specializing in arthritis, autoimmune diseases, and biologic therapies. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Screening Who Treats Osteoporosis? Diagnosis and Treatment Finding the Right Provider Frequently Asked Questions The right specialists and other healthcare providers can treat and manage osteoporosis to help prevent complications. This condition of progressive bone loss can significantly increase your risk of bone fracture and contribute to higher rates of disability and even mortality if left unmanaged. Treatment for osteoporosis can include medication, nutritional modifications, physical therapy, exercise, and more. This article will detail the various specialists who treat osteoporosis and explain their roles in managing this condition. Marko Geber / Getty Images How to Know if You Need Osteoporosis Treatment Osteoporosis often has no symptoms. But it can lead to fragility fractures (in which weakened bones break with minor trauma). If you have a fracture of the distal radius (wrist), proximal humerus (shoulder), hip, or spine, the healthcare provider may suspect osteoporosis. Seeing compression fractures on X-ray can indicate osteoporosis. Without symptoms, getting screened for osteoporosis is the first step in determining whether you need treatment. To do this, you need to take a bone density (DEXA) scan, a diagnostic test that can assess the quality and thickness of the bones in several regions of your body. When citing health authorities or research, the following will use their terms for sex or gender. Because osteoporosis typically occurs in females who have completed menopause and in older males, regular DEXA scans are recommended for females at average risk over age 65. Males have a higher risk of osteoporosis over age 70 and may consider screening. Transgender people should discuss their risk with a healthcare provider to determine whether screening is recommended. Medicare only covers bone density screening for women. In addition, younger individuals with other risk factors for osteoporosis may require earlier screening. Higher-risk groups include: People who are petite or slender Individuals with low vitamin D or calcium levels People taking cancer or long-term corticosteroid medications Individuals with a family history of osteoporosis or fragility fractures White or Asian people Chronic smokers or heavy alcohol users Who Treats Osteoporosis? Osteoporosis typically affects multiple regions of the body at the same time. Because of this, a wide variety of specialists may assume a role in treating the disease. The following types of providers are most commonly involved in managing this condition. Primary Care Provider A primary care physician or other primary care healthcare provider (such as a physician assistant or nurse practitioner) is often the first line of defense when it comes to screening for osteoporosis. They will typically look for potential risk factors during your annual physical and order a bone density scan if necessary. In addition, your height, weight, and posture are routinely assessed during your appointment to help detect and diagnose this condition. Rheumatologist Rheumatologists are specialists in treating systemic conditions that impact the bones, muscles, tendons, and ligaments. People with osteoporosis are frequently referred to this type of physician when they have been diagnosed with osteoporosis or after a fragility fracture. Your rheumatologist may order blood or urine tests to determine the levels of calcium and vitamin D in your body. They may also prescribe medication meant to improve your bone density by decreasing the breakdown of old bone or promoting new bone formation. Endocrinologist Endocrinologists are experts in treating diseases related to hormone imbalances. Because osteoporosis typically arises after the hormonal changes associated with menopause, people with the disease frequently see this type of specialist. Much like a rheumatologist, your endocrinologist will usually order lab tests to determine the calcium, vitamin, and hormone levels in your body. Based on these results, they may also prescribe medications meant to stave off further bone loss or prevent a fracture. Gynecologist Gynecologists are specialists in women's health. Because osteoporosis disproportionately affects females, a gynecologist may be the first healthcare provider to detect the signs of low bone density and initiate treatment. A gynecologist can order a DEXA scan if it is age-appropriate or if other risk factors are present that make it necessary. They also frequently prescribe bone density medications and counsel you on dietary changes that may benefit your bones if you have osteoporosis. Geriatrician Geriatricians specialize in managing the health of older adults. Because most women who get osteoporosis are over the age of 65 and most men are over the age of 70, this type of provider can be particularly valuable. Much like the previous specialists listed, geriatricians can order DEXA scans and blood tests. They can also prescribe medications that help prevent fractures and stabilize your bone density. In addition, geriatricians are particularly skilled in treating osteoporosis in tandem with other health concerns that are more common in aging individuals. Physical Therapist In addition to medications, certain types of exercise can help build bone density and reduce the effects of osteoporosis. Weight-bearing exercises (like walking) and resistance training are particularly beneficial. Physical therapists are skilled in prescribing effective exercise techniques that can help manage this condition. They can also instruct you in movement strategies that allow you to safely perform daily activities like lifting, carrying, and squatting. Orthopedic Surgeon Unfortunately, osteoporotic bones with diminished density have a higher likelihood of fracturing. When this occurs, an orthopedic surgeon is commonly consulted. This type of specialist will typically order imaging to assess the nature and degree of the break and may need to perform surgery to stabilize the affected bone. Osteoporosis Diagnosis and Treatment DEXA scans are the primary means of diagnosing osteoporosis. When a scan is complete, you typically receive a T-score for areas like your radius (wrist), femur (hip), and lumbar (low back) spine. This score compares these areas to healthy individuals with peak bone density. If your bone density is more than 2.5 standard deviations lower, you have osteoporosis. Several types of treatment can help manage osteoporosis. These include: Medications that help preserve bone density and prevent fractures Nutritional changes emphasizing appropriate vitamin D and calcium intake Lifestyle modifications like smoking cessation and drinking only in moderation Regular weight-bearing and resistance training exercises How to Find the Right Healthcare Provider Finding a healthcare provider who is skilled in treating osteoporosis is the key to properly managing this chronic condition. Start with a primary care healthcare provider. They can evaluate your individual needs and, if necessary, refer you to one (or several) specialists. In addition, the Bone Health & Osteoporosis Foundation’s website can also help you locate a knowledgeable provider in your area. Summary Osteoporosis is a disease that leads to diminished bone density and an increased risk of a fracture. Several types of providers are skilled in managing this condition. These providers can help screen for, diagnose, and treat this chronic diagnosis. Medications, diet and lifestyle changes, and exercise are the primary tools that are utilized. Frequently Asked Questions How does physical therapy help with osteoporosis? Physical therapy teaches exercises that can positively affect your bone density. This commonly includes weight-bearing exercises and resistance training techniques. Your therapist can also guide you on the safest ways to perform daily activities like lifting, carrying, and performing household chores. Learn More: Physical Therapy for Older Adults Is it better to see a rheumatologist or an endocrinologist? Both a rheumatologist and an endocrinologist are skilled in treating osteoporosis. Rheumatologists specialize in systemic diseases that affect the body’s bones, tendons, ligaments, and joints while endocrinologists focus on hormone-related conditions. Both types of providers are able to order screening tests and prescribe treatments for osteoporosis. Learn More: Secondary Osteoporosis What should you expect during your first appointment for osteoporosis? During your first osteoporosis appointment, your healthcare provider will typically ask you about your health history and screen for any osteoporosis risk factors. They may also assess your posture, body weight, and height and compare them to earlier measurements. Finally, they may order a blood or urine test and a bone density scan to confirm or rule out the diagnosis. Learn More: Osteoporosis Diagnosis 10 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. Akkawi I, Zmerly H. Osteoporosis: current concepts. Joints. 2018;06(02):122-127. doi:10.1055/s-0038-1660790 Tsuda T. Epidemiology of fragility fractures and fall prevention in the elderly: a systematic review of the literature. Current Orthopaedic Practice. 2017;28(6):580-585. doi:10.1097/bco.0000000000000563 Curry SJ, Krist AH, DK Owens et al. Screening for osteoporosis to prevent fractures: US Preventive Services Task Force recommendation statement. JAMA. 2018;319(24):2521. doi:10.1001/jama.2018.7498 Johns Hopkins Medicine. Osteoporosis. UCSF Gender Affirming Health Program. Bone health and osteoporosis. Centers for Medicare and Medicaid Services. Bone mass measurements. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Osteoporosis. American College of Rheumatology. What is a rheumatologist? Updated May 2021. The American College of Obstetricians and Gynecologists. About us. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Osteoporosis: diagnosis, treatment, and steps to take. By Tim Petrie, DPT, OCS Tim Petrie, DPT, OCS, is a board-certified orthopedic specialist who has practiced as a physical therapist for more than a decade. 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