Did you know your bones are made of living tissue? In order for them to stay strong, your body continuously breaks down old bone and replaces it with new bone. If your body can no longer keep up with this process, osteoporosis occurs and causes bones to become weak and brittle.
The inside of a bone looks a bit like a honeycomb. For someone with osteoporosis, the bone (or the “walls” of the honeycomb) get smaller, while the spaces between the bone get larger. The outer layers of the bone also get thinner. Because of these changes, the bone becomes weaker.
Osteoporosis is often called a “silent disease” because people often don’t notice anything is wrong until a bone breaks.
Once your bones become weak, symptoms may include back pain due to a fractured or collapsed vertebra, a stooped posture, loss of height, and trouble breathing (less lung capacity due to compressed disks). A small fall or minor stress — like bending over or coughing — may cause a fracture to a bone, usually in the hip, spine, or wrist. It’s also more difficult for people with osteoporosis to recover from broken bones. Sometimes, these fractures lead to chronic pain. Broken hip and spine bones are particularly problematic, as these injuries significantly decrease mobility and independence for older adults.
Although anyone can develop osteoporosis, certain individuals are more likely to develop the disease. It affects one in five women over the age of 50 but only one in 20 men. Additionally, white and Asian women are more likely to develop osteoporosis. Other risk factors may include:
- A family history of broken bones or osteoporosis
- A personal history of a broken bone after age 50
- Surgery to remove your ovaries before menstruation stopped naturally
- Poor dietary habits, including low consumption of calcium, vitamin D, and/or protein
- An inactive lifestyle or prolonged periods of bedrest
- Heavy use of alcohol
- Repeated use of certain medications, including corticosteroids, proton pump inhibitors, and anti-epileptic medications
- Incorrect levels of hormones, such as too much thyroid hormone, too little estrogen (women), or too little testosterone (men)
- Underweight or low body mass index (BMI)
As the list above shows, the risk of osteoporosis increases with age.
In the first several years after menopause, women tend to lose bone mass quickly. Eventually, the loss slows down but still continues. For men, the loss is slower, but by age 65 or 70, it occurs at the same rate for both men and women.
If the most common symptom of osteoporosis is a broken bone, how is it diagnosed? Your primary care physician can use screening tools, like questionnaires, physical exams, and ultrasounds, to test for osteoporosis and predict your risk of having low bone density. Additionally, a bone density scan can measure the strength of your bones. This test compares your bone density to that of a healthy, young adult. Your T-score indicates if you have osteoporosis or osteopenia, which is less severe low bone density.
If you are a woman over the age of 65, it is recommended that you get tested for osteoporosis. You should also be tested if you are younger than 65 but at greater risk based on the list above. Depending on your test results, your doctor may recommend lifestyle changes (like a healthy diet and regular exercise) and/or medications to ease your symptoms and lower your chance of breaking a bone.