Bones are constantly changing. Old bone tissue breaks down, and new bone tissue takes its place. When bone breaks down faster than new bone is formed, bones become fragile, less dense and more likely to break. As bone formation slows, you may develop low bone mass (osteopenia). When bone loss (referred to clinically as bone resorption) reaches a certain point as measured in a bone density test, it is considered osteoporosis.

Osteoporosis is a common and serious condition that can affect anyone, regardless of gender. Osteoporosis can result in fractures, chronic pain and loss of height. A fracture can cause anxiety, depression, a fear of falling, disability and death. A fracture is most often the result of a fall, although people with osteoporosis can experience a broken bone even when doing simple household tasks.

Until about age 30, bones are usually larger, stronger and denser, because new bone is formed faster than old bone is broken down. Bone breakdown increases during the first few years after menopause and happens faster throughout the postmenopausal years. When breakdown happens faster than formation, bones become fragile and weak.

Osteoporosis prevention with strong bones starts now, no matter your age. The International Osteoporosis Foundation notes that prevention begins in childhood with a healthy diet and plenty of exercise to build a high bone mass into adulthood. Adults can take steps to prevent osteoporosis by improving their diet, getting enough exercise and dropping certain lifestyle habits.

Healthy lifestyle habits include:

• Balance exercises
• Weight-bearing and muscle-strengthening exercises
• Fall prevention and spine precautions
• Daily calcium and vitamin D intake
• Smoking cessation
• Limiting alcohol and caffeine intake

Osteoporosis Risk Factors

Age, race and genetics are risk factors you have no control over. Lifestyle, nutrition and diet are risk factors you can change to reduce your fracture risk.

• Age: Everyone loses bone mass as they age. Peak bone mass happens at about age 35, then the body replaces less old bone with new bone. The older you are, the more likely you will develop osteoporosis.
• Reduced estrogen: Estrogen keeps women’s bones strong. A postmenopausal woman’s body makes much less estrogen, increasing the risk of osteoporosis. Women lose up to 20% of their bone density in the five to seven years after menopause.
• Gender/genetics: Women are at a higher risk of developing osteoporosis, but men also can be at risk. Half of women and 1 in 4 men ages 50 and older break a bone due to osteoporosis. A family history of osteoporosis or a history of a previous hip or spine fracture adds to your risk.
• Ethnicity: Osteoporosis risk is higher for whites or Asians, or individuals with fair skin.
• Nutrition and body size: Eating poorly and not eating enough foods that contain calcium and vitamin D can increase your risk. Your risk also increases with being small or thin, having low body weight or having low bone density.
• Medications: Long-term use of steroids, anticonvulsants, blood thinners and other medications also can increase your risk.
• Lifestyle: Inactivity or infrequent exercise can contribute to bone loss. Cigarette smoking and consuming large amounts of alcohol or caffeine over time also increases risk.
• Illnesses: Some illnesses, such as thyroid disease, parathyroid disease, autoimmune diseases and chronic lung diseases may increase your risk of osteoporosis.
• Previous fractures can increase the risk of osteoporosis.

Diagnosing Osteoporosis

A bone densitometry DEXA (dual energy X-ray absorptiometry) scan or other bone mineral density test is the best way to measure bone health. The test is like an X-ray of the hip and spine. It’s painless and noninvasive.

You don’t need to make any special preparations for a DEXA scan. You’ll lie flat on your back and will need to stay still to prevent blurring the image. A scanning arm will pass over you, sending low-dose X-rays through your body to see how much isn’t absorbed by tissue such as bone. The scan takes less than a half hour, and you’ll go home afterward.

The test gives a good indication of bone strength and is part of determining whether treatment is necessary.

Additional testing every two years can help your health care provider determine the effectiveness of your treatment plan.

Blood and urine tests can determine how much calcium, vitamin D, thyroid hormone and parathyroid hormone are present in your body. Additional blood tests may be performed to ensure there are no secondary causes of low bone density.

The U.S. Preventive Services Task Force (USPSTF) recommends bone measurement testing to prevent fractures in women over age 65. Screening is also recommended after menopause for those under age 65 if recommended by their medical provider. The USPSTF has determined that there isn’t enough evidence to warrant screening in men.

Your provider may seek a screening based on your health, including loss of height or risk factors, including for men ages 70 and older.

Osteoporosis Symptoms

People with osteoporosis cannot feel their bones weaken, and many do not know they have osteoporosis until they break a bone. Low bone mass or osteopenia usually does not cause symptoms, even while osteoporosis is developing.

As bone density loss increases and the disease worsens, your bones become weak and brittle. You may break a bone after a sudden strain, bump or fall. Known as an osteoporotic fracture, a break usually will occur in the hip, spine, wrist or shoulder.

A collapsed vertebra (bone in your spine), also known as a compression spinal fracture, may cause severe back pain or loss of height, with a stooped or bent-over posture.

Osteoporosis Treatment

There is no cure for osteoporosis, but medications have been shown to slow or stop its progress. Some can improve bone density.

Osteoporosis medication along with healthy lifestyle modifications, such as ensuring adequate calcium, vitamin D and exercise, can help reduce the risk of a bone fracture.

Care That’s Focused on You

• Minimally invasive procedures can have you home quickly with less pain and faster recovery.
• Sophisticated pain management aims to keep you comfortable and safe.
• We have a deep commitment to getting you moving again and managing your pain so you can keep up with your physical therapy.
• With 30 orthopedic locations in Louisville, Southern Indiana and surrounding communities, we have specialists near you.
• Communicate with your provider, manage appointments, refill prescriptions and more, anytime, from a computer or mobile device with a free Norton MyChart account.

Why Choose Norton Orthopedic Institute

More patients choose Norton Orthopedic Institute for hip or knee replacements and other orthopedic procedures than any other health care provider in Louisville or Southern Indiana.

• About 50 providers, including board-certified and fellowship-trained orthopedic surgeons, offer care at twelve locations in Louisville and Southern Indiana.
• Same-day appointments often are available.
• Norton Healthcare is the first health system in the nation to be recognized as an Advanced Orthopedic & Spine Center of Excellence by DNV.
• Our hip replacement specialists are pioneers in minimally invasive surgeries focused on minimizing pain and recovery time.
• Robotic-assisted surgical techniques improve precision for a more natural-feeling knee replacement to get you moving again.
• Educational programs help patients prepare for joint replacement surgery and recovery.
• Medicare, Medicaid and most major commercial insurance plans are accepted.
• Your free Norton MyChart account allows you to communicate with your provider, manage appointments, get alerted if an earlier appointment becomes available, refill prescriptions and more from a mobile device or computer.
• KORT Physical Therapy offers a variety of services, in partnership with Norton Healthcare, at convenient locations throughout Louisville and Southern Indiana. Find a location near you or request an appointment today.