Osteoporosis

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Osteoporosis occurs when bones become weak and brittle, increasing the risk of bone fracture. Any bone can be affected, but areas of concern include the hip, spine and wrist.

How Osteoporosis Happens

Throughout your life, your body removes old bone and adds new bone to your skeleton. After age 30, more bone is lost than replaced. If too much bone loss occurs, this may lead to osteoporosis. Osteoporosis is more likely to occur if full bone mass was not achieved during your bone-building years.

You can best defend against bone loss by building strong bones throughout your early years. Get enough calcium, vitamin D and regular exercise to keep your bones strong throughout life.

normal bone compared to osteoporosis
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Risk Factors

Factors that may increase your chance of developing osteoporosis include:

  • Aging
  • Low weight
  • Smoking
  • Alcohol abuse
  • History of falls
  • Family history of osteoporosis
  • Postmenopausal status
  • Certain conditions, such as:
    • Rheumatoid arthritis
    • Amenorrhea (no menstrual periods)
    • Hyperthyroidism
    • Type 2 diabetes
    • Asthma
    • Liver disease
    • Eating disorder
    • Depression
    • Crohn's disease
  • Use of certain medications, such as antidepressants, long-term heparin, corticosteroids, anticonvulsants or antacids
  • Low hormone levels (low estrogen levels in women, low testosterone levels in men)
  • Inactive lifestyle
  • Certain restrictive diets that may result in a deficit of calcium or vitamin D
  • Too little sunlight (the effect of sun on the skin is a primary source of vitamin D)
  • Certain cancers, including lymphoma and multiple myeloma

Symptoms

In most cases, people with osteoporosis remain symptom-free until a bone fracture happens. In those that do have symptoms, osteoporosis may cause:

  • Severe back pain with fracture of the vertebrae, wrists, hips or other bones
  • Loss of height with stooped posture, a condition called kyphosis

Diagnosing Osteoporosis

Bone mineral density (BMD) tests of the hip, spine or wrist to identify osteoporosis include:

  • Central or peripheral dual-energy X-ray absorptiometry (DXA)
  • Quantitative ultrasound (QUS)
  • Central or peripheral quantitative CT scan (QCT)

Treatment 

Although osteoporosis can be prevented, it cannot be cured. The treatment and management of osteoporosis involves lifestyle changes and medications. 

Manage the risks that come with bone loss by making healthy choices, including:

  • Eating a balanced diet rich in calcium and vitamin D
  • Not smoking
  • Doing weight-bearing, strength-training and balance building exercises
  • Taking calcium or Vitamin D supplements
  • Avoiding falls

Your doctor may prescribe medications that help prevent bone loss and bone fractures, while increasing bone density, including:

  • Bisphosphonates 
  • Hormone therapy
  • Anabolic therapy

Bisphosphonates Alternatives

Oral bisphosphonates improve bone density and reduce fracture risk. However, some patients can't tolerate them or find them ineffective.

At UVA, we over alternatives for patients:

  • With esophageal irritation, we can consider a yearly intravenous bisphosphonate
  • Who have bone pain or dental issues, we offer the option of a twice-yearly medicine by injection 

Both of these medications lead to greater bone density gains and fracture reduction compared to oral bisphosphonates. 

For patients with severely low bone density and active vertebral fractures, we can offer the option of a daily injectable medication that reduces vertebral fractures by 80 percent.

Osteoporosis Research at UVA

Our endocrinologists continue to actively research novel medicines and therapies, including the use of stem cell therapies, new hormone proteins and other innovative drug variations.

 

Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.