Osteoporosis: Causes, symptoms, diagnostic tests, and how to treat

OsteoporosisOsteoporosis is a condition of reduced bone density and fragile bones. It leads to abnormally porous bone that is compressible, similar to that of a sponge. Porous bone is very weak and easily fractured.

Normally, our bones are composed of adequate amounts of protein, collagen, and calcium, giving them strength. However, in cases of osteoporosis, the structure and strength are compromised.


Osteoporosis can affect both men and women, but postmenopausal women make up the majority of cases. Over 40 million people in the United States are estimated to have the bone disease, with an estimated 1,000 fractures happening every hour around the world due to osteoporosis complications.

Causes, risk factors, and complications of osteoporosis

When we’re young, our bones are constantly going through a state of renewal. This means that old bone is broken down to make way for new bone. It’s a normal process that ensures bone health. Our youth allowed for us to make new bone faster that it breaks down, increasing bone mass.

As we reach more advanced ages, this process does not occur as rapidly. The rate of bone breakdown can outpace bone building.

Peak bone density is typically reached in our late 20s. A gradual weakening after the age of 35 is commonly observed. This natural weakening is more pronounced in some individuals, leading to osteoporosis.

A number of risk factors raise the likelihood of osteoporosis development. They are as follows:

Non-modifiable risk factors

  • Age – osteoporosis risk increases with age
  • Ethnicity – risk is higher in the White and Asian population
  • Bone structure – those with small bone structures are viewed as high risk
  • Genetics – having a family history of osteoporosis, especially in a parent or sibling, greatly increases your chances of developing the bone disease.
  • Fracture history – osteoporosis risk is higher in people with a previous fracture during a low-level injury. This is especially true of injuries occurring after the age of 50.

Modifiable risk factors

  • Reduced sex hormones – especially in women, as decreases in estrogen during menopause are associated with an increased osteoporosis risk
  • Anorexia nervosa and bulimia (eating disorders)
  • Tobacco smoking
  • Excessive alcohol intake
  • Low levels of calcium, magnesium, and vitamin D – possibly due to low intake, malabsorption, or the use of certain medications
  • Lack of activity or immobility – weight bearing exercise place a degree of stress on the bone required for bone growth.

The development of osteoporosis can also be caused by hormone imbalances resulting from disease. Several hormones are required for normal bone growth and maintenance. Diseases that affect hormone levels includes hyperthyroidism, hyperparathyroidism, and Cushing’s disease.

Autoimmune disorders such as rheumatoid arthritis and ankylosing spondylitis are also associated with an increased risk of osteoporosis

Being in constant risk of bone fractures throughout the body can lead to several debilitating complications. The most serious of which are bone fractures of the spine or hip. These are commonly the result of falls and lead to long-term disability or an increased risk of death within the first year of the fracture.

Symptoms of osteoporosis

During early stages of the bone disease, virtually no symptoms are present, but unknowingly to you, your bones are weakening. In the majority of cases, a patient may only discover they have osteoporosis after they experience a fall or injury that leads to a fracture, especially if the injury is minor.

Minor injuries that lead to bone fractures include slipping, a simple cough, or even a sneeze. Commonly, breaks occur in the hip, wrist, or in the spinal vertebrae.

Signs and symptoms of osteoporosis also include:

  • Back pain caused by a fractured or collapses vertebra
  • Loss of height
  • Stooped posture
  • Bone fractures to occur easily than expected.

Diagnosing osteoporosis

Often, a diagnosis of osteoporosis occurs after a fracture. At this point, the bone has already reached a level that is much thinner and lighter than normal bone. This is often appreciated once your doctor has ordered an x-ray that shows at least 30 percent of your bone has deteriorated.

While x-rays are a useful test, they are not accurate indicators of bone density. This is why doctors use the DXA (dual-energy X-ray absorptiometry) scan.
DXA scans can be used to diagnosis osteoporosis. The test typically measures bone density of the hip, the spine, and the forearm, taking only five to fifteen minutes to complete. While DXA scans do expose the patient to radiation, it is far less than the amount sustained through a standard chest x-ray.

Related: Osteoporosis diet plan: Foods to eat and avoid

Treating and preventing osteoporosis

When diagnosed, your doctor may prescribe medication. They could be:

  • Bisphosphonates: An antiresorptive drug that slows down bone loss, reducing fracture risk.
  • Estrogen agonist/antagonist: Approved for use in post-menopausal women and shown to decrease the risk of spine fractures.
  • Calcitonin: A quick-acting drug that helps promote bone formation.
  • Parathyroid hormone: Promotes bone formation through the use of this hormone.


Considering that the majority of osteoporosis cases are attributed to modifiable risk factors, changing certain aspects of your lifestyle can help reduce your risk. Making sure you are getting the proper number of vitamins and minerals required for good bone health goes far in helping reduce fracture risk.

The following are various habits you can adopt to maintain healthy bone mineral density and prevent fractures.

  • Getting enough calcium: This mineral is commonly found in our diet, but as we get older, we need more of it. Adequate calcium intake is approximately 1,000–1,200mg per day. Higher amounts are commonly needed by women over the age of 50 and in both sexes over the age of 70. Foods that are good sources of calcium include low-fat dairy products, dark green leafy vegetables, and calcium-fortified cereals.
  • Getting enough vitamin D: This vitamin is actually required for calcium absorption. Vitamin D can be found in various foods such as egg yolks, saltwater fish, and liver. It is recommended to get 600IU of vitamin D on a daily basis, and 800IU is required in men and women over the age of 70.
  • Quit smoking: Cigarette smoking is known to reduce bone growth and decrease estrogen levels in women.
  • Consume alcohol in moderation: Excessive alcohol drinking often results in poor nutrition and increases fall risk.
  • Increase exercise: Weight bearing exercise is important to strengthen bones. It helps to stimulate bone formation, making them strong and healthy. Exercise also helps strengthen your muscles, making it less likely that weakness will lead to potentially injurious falls. Yoga is a good exercise, as it promotes posture and balance, helping reduce the risk of falls and fractures.

Related: Can osteoporosis be reversed? 12 natural ways to treat osteoporosis

Author Bio

Emily Lunardo studied medical sociology at York University with a strong focus on the social determinants of health and mental illness. She is a registered Zumba instructor, as well as a Canfit Pro trainer, who teaches fitness classes on a weekly basis. Emily practices healthy habits in her own life as well as helps others with their own personal health goals. Emily joined Bel Marra Health as a health writer in 2013.



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