Osteoporosis is a disease that thins and weakens the bones to the point that they become fragile and break easily. Women and men with osteoporosis most often break bones in the hip, spine, and wrist, but any bone can be affected. You can't "catch" osteoporosis or give it to someone else.
Risk Factors and Prevention
There are no symptoms of osteoporosis until a fracture occurs. That is why it is often called "silent." Certain factors can put you at risk for developing osteoporosis, but there are also steps you can take to prevent it.
Osteoporosis does not have any symptoms until a fracture occurs. Women and men with osteoporosis most often break bones in the hip, spine, and wrist. But any fracture in an older person could be a warning sign that the bone is weaker than optimal.
Some people may be unaware that they have already experienced one or more spine fractures. Height loss of one inch or more may be the first sign that someone has experienced spine fractures due to osteoporosis. Multiple spine fractures can cause a curved spine, stooped posture, back pain, and back fatigue.
Women and men who have had a fracture are at high risk of experiencing another one. A fracture over the age of 45 or several fractures before that age may be a warning sign that a person has already developed osteoporosis. People over the age of 45 who have experienced a fracture should talk to their doctor about getting evaluated for osteoporosis.
The test used to diagnose osteoporosis is called a bone density test. This test is a measure of how strong -- or dense -- your bones are and can help your doctor predict your risk for having a fracture. Bone density tests are painless, safe, and require no preparation on your part.
Bone density tests compare your bone density to the bones of an average healthy young adult. The test result, known as a T-score, tells you how strong your bones are, whether you have osteoporosis or osteopenia -- low bone mass -- and your risk for having a fracture.
Some bone density tests measure the strength of the hip, spine, and/or wrist, which are the bones that break most often in people with osteoporosis. Other tests measure bone in the heel or hand. Although no bone density test is 100 percent accurate, it is the single most important diagnostic test to predict whether a person will have a fracture in the future.
The preferred bone density test is a DXA scan of the hip and spine. This test shows if you have normal bone density, low bone mass, or osteoporosis. It is the only bone density test that can be used to diagnose osteoporosis and monitor bone density changes over time in response to treatment.
The United States Preventive Service Task Force recommends that women aged 65 and older be screened for osteoporosis, as well as women aged 60 and older who are at increased risk for an osteoporosis-related fracture. However, the decision of whether or not to have a bone density test is best made between a patient and his or her physician.
Medicare will usually cover the cost of a bone density test in women age 65 and older. Under certain conditions, such as significant risk factors for osteoporosis, Medicare will cover women under age 65, men, and a followup bone density test every 2 years for certain individuals.
Treatment and Research
Although there is no cure for osteoporosis, it can be treated. If your doctor does not specialize in osteoporosis, he or she can refer you to a specialist. There is not one type of doctor who cares for people with osteoporosis.
Many family doctors have been learning about osteoporosis and can treat people who have it. Endocrinologists, rheumatologists, geriatricians, and internists are just a few of the specialists who can provide care to people with osteoporosis.
The goal of treatment is to prevent fractures. A balanced diet rich in calcium, adequate vitamin D, a regular exercise program, and fall prevention are all important for maintaining bone health.
Osteoporosis Treatment Medications
Several medications are approved by the Food and Drug Administration for the treatment of osteoporosis. Since all medications have side effects, it is important to talk to your doctor about which medication is right for you.
Bisphosphonates. Alendronate, risedronate, ibandronate, and zoledronic acid are from a class of drugs called bisphosphonates that slow bone loss, reduce fracture risk, and in some cases increase bone density. These drugs decrease the activity of bone-dissolving cells.
Alendronate is an oral medication in pill or liquid form and is available in daily and weekly doses for treating women and men. Risedronate is available in pill form in daily, weekly, and twice monthly doses for treating women and men. Ibandronate is available in a pill as a monthly dose or as an intravenous injection given once every 3 months for treating women. Zoledronic acid is available as an intravenous injection given once a year for treating women. Side effects of taking oral bisphosphonates may include nausea, heartburn, and stomach pain, including serious digestive problems if they are not taken properly.
A few people have muscle, bone, or joint pain while using these medicines. Side effects of intravenous bisphosphonates may include flu-like symptoms such as fever, pain in muscles or joints, and headaches. These symptoms usually stop after a few days. In rare cases, osteonecrosis of the jaw has occurred in people taking bisphosphonates.
Estrogen. Estrogen is approved for the treatment of menopausal symptoms and osteoporosis. Because of recent evidence that breast cancer, strokes, blood clots, and heart attacks may be increased in some women who take estrogen, the Food and Drug Administration recommends that women take the lowest effective dose for the shortest period possible. Estrogen should only be considered for women at significant risk for osteoporosis, and nonestrogen medications should be carefully considered first.
Raloxifene, available as a daily pill, is approved for use in postmenopausal women. From a class of drugs called estrogen agonists/antagonists, commonly referred to as selective estrogen receptor modulators (SERMs), raloxifene is a nonhormonal drug that has estrogen-like effects on the skeleton, but blocks estrogen effects in the breast and uterus. Raloxifene slows bone loss and reduces the risk of fractures in the spine, but no effect on hip fracture has been seen. Side effects may include hot flashes and an increased risk of blood clots in some women.
Calcitonin, available as a daily nasal spray or injection, is approved for the treatment of osteoporosis in women who are at least 5 years past menopause. It is a hormone produced by the thyroid gland that slows bone loss and reduces the risk of spine fractures. It has no serious side effects.
Teriparatide, a form of human parathyroid hormone, stimulates new bone formation. Given as a daily injection for up to 24 months, it increases bone tissue and bone strength, and has been shown to reduce the risk of spine and other fractures.Teriparatide is approved for use in postmenopausal women and men who are at high risk of fracture. Some patients experience leg cramps and dizziness from teriparatide.
Research
Research is currently underway to identify new treatments for osteoporosis. Studies are also underway to learn new ways to achieve the best possible bone health.
Scientists are also studying the impact of electromagnetic therapy and nutrients like vitamin K and phytoestrogens on bone health. The role of genetics and the environment in the development of osteoporosis is also being explored.
Risk Factors and Prevention
There are no symptoms of osteoporosis until a fracture occurs. That is why it is often called "silent." Certain factors can put you at risk for developing osteoporosis, but there are also steps you can take to prevent it.
Osteoporosis does not have any symptoms until a fracture occurs. Women and men with osteoporosis most often break bones in the hip, spine, and wrist. But any fracture in an older person could be a warning sign that the bone is weaker than optimal.
Some people may be unaware that they have already experienced one or more spine fractures. Height loss of one inch or more may be the first sign that someone has experienced spine fractures due to osteoporosis. Multiple spine fractures can cause a curved spine, stooped posture, back pain, and back fatigue.
Women and men who have had a fracture are at high risk of experiencing another one. A fracture over the age of 45 or several fractures before that age may be a warning sign that a person has already developed osteoporosis. People over the age of 45 who have experienced a fracture should talk to their doctor about getting evaluated for osteoporosis.
The test used to diagnose osteoporosis is called a bone density test. This test is a measure of how strong -- or dense -- your bones are and can help your doctor predict your risk for having a fracture. Bone density tests are painless, safe, and require no preparation on your part.
Bone density tests compare your bone density to the bones of an average healthy young adult. The test result, known as a T-score, tells you how strong your bones are, whether you have osteoporosis or osteopenia -- low bone mass -- and your risk for having a fracture.
Some bone density tests measure the strength of the hip, spine, and/or wrist, which are the bones that break most often in people with osteoporosis. Other tests measure bone in the heel or hand. Although no bone density test is 100 percent accurate, it is the single most important diagnostic test to predict whether a person will have a fracture in the future.
The preferred bone density test is a DXA scan of the hip and spine. This test shows if you have normal bone density, low bone mass, or osteoporosis. It is the only bone density test that can be used to diagnose osteoporosis and monitor bone density changes over time in response to treatment.
The United States Preventive Service Task Force recommends that women aged 65 and older be screened for osteoporosis, as well as women aged 60 and older who are at increased risk for an osteoporosis-related fracture. However, the decision of whether or not to have a bone density test is best made between a patient and his or her physician.
Medicare will usually cover the cost of a bone density test in women age 65 and older. Under certain conditions, such as significant risk factors for osteoporosis, Medicare will cover women under age 65, men, and a followup bone density test every 2 years for certain individuals.
Treatment and Research
Although there is no cure for osteoporosis, it can be treated. If your doctor does not specialize in osteoporosis, he or she can refer you to a specialist. There is not one type of doctor who cares for people with osteoporosis.
Many family doctors have been learning about osteoporosis and can treat people who have it. Endocrinologists, rheumatologists, geriatricians, and internists are just a few of the specialists who can provide care to people with osteoporosis.
The goal of treatment is to prevent fractures. A balanced diet rich in calcium, adequate vitamin D, a regular exercise program, and fall prevention are all important for maintaining bone health.
Osteoporosis Treatment Medications
Several medications are approved by the Food and Drug Administration for the treatment of osteoporosis. Since all medications have side effects, it is important to talk to your doctor about which medication is right for you.
Bisphosphonates. Alendronate, risedronate, ibandronate, and zoledronic acid are from a class of drugs called bisphosphonates that slow bone loss, reduce fracture risk, and in some cases increase bone density. These drugs decrease the activity of bone-dissolving cells.
Alendronate is an oral medication in pill or liquid form and is available in daily and weekly doses for treating women and men. Risedronate is available in pill form in daily, weekly, and twice monthly doses for treating women and men. Ibandronate is available in a pill as a monthly dose or as an intravenous injection given once every 3 months for treating women. Zoledronic acid is available as an intravenous injection given once a year for treating women. Side effects of taking oral bisphosphonates may include nausea, heartburn, and stomach pain, including serious digestive problems if they are not taken properly.
A few people have muscle, bone, or joint pain while using these medicines. Side effects of intravenous bisphosphonates may include flu-like symptoms such as fever, pain in muscles or joints, and headaches. These symptoms usually stop after a few days. In rare cases, osteonecrosis of the jaw has occurred in people taking bisphosphonates.
Estrogen. Estrogen is approved for the treatment of menopausal symptoms and osteoporosis. Because of recent evidence that breast cancer, strokes, blood clots, and heart attacks may be increased in some women who take estrogen, the Food and Drug Administration recommends that women take the lowest effective dose for the shortest period possible. Estrogen should only be considered for women at significant risk for osteoporosis, and nonestrogen medications should be carefully considered first.
Raloxifene, available as a daily pill, is approved for use in postmenopausal women. From a class of drugs called estrogen agonists/antagonists, commonly referred to as selective estrogen receptor modulators (SERMs), raloxifene is a nonhormonal drug that has estrogen-like effects on the skeleton, but blocks estrogen effects in the breast and uterus. Raloxifene slows bone loss and reduces the risk of fractures in the spine, but no effect on hip fracture has been seen. Side effects may include hot flashes and an increased risk of blood clots in some women.
Calcitonin, available as a daily nasal spray or injection, is approved for the treatment of osteoporosis in women who are at least 5 years past menopause. It is a hormone produced by the thyroid gland that slows bone loss and reduces the risk of spine fractures. It has no serious side effects.
Teriparatide, a form of human parathyroid hormone, stimulates new bone formation. Given as a daily injection for up to 24 months, it increases bone tissue and bone strength, and has been shown to reduce the risk of spine and other fractures.Teriparatide is approved for use in postmenopausal women and men who are at high risk of fracture. Some patients experience leg cramps and dizziness from teriparatide.
Research
Research is currently underway to identify new treatments for osteoporosis. Studies are also underway to learn new ways to achieve the best possible bone health.
Scientists are also studying the impact of electromagnetic therapy and nutrients like vitamin K and phytoestrogens on bone health. The role of genetics and the environment in the development of osteoporosis is also being explored.
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