What is osteoporosis?
Osteoporosis literally means "porous bone." As we age, our bones naturally lose thickness and strength. Osteoporosis leads to an increased risk of fractures (breaks). Called the "silent crippler," osteoporosis often progresses without symptoms or pain until a fracture occurs.
Osteoporosis is a major health threat for more than 28 million Americans (80 percent of whom are women). The disease is responsible for more than 1.5 million fractures each year. If left untreated, osteoporosis can be both debilitating and painful.
Hip fractures are a serious health consequence of osteoporosis. After menopause, the risk of osteoporosis is increased in the vertebral body of the spine, wrist, and hip. About 20 percent of patients have a hip fracture in the first year after being diagnosed with osteoporosis. Hip fractures often result in a loss of independence and the need for nursing home care. Medical complications after hip fractures can be life threatening.
The best way to avoid osteoporosis is to determine your risk and then take steps to prevent the disease. It is important to start early. With proper diet and exercise, you might be able to slow or prevent the onset of osteoporosis. If you already have the disease, early detection and proper medical care can help slow or even reverse its progress.
Are you at risk?
Bone loss in women begins at about age 30 and accelerates after menopause. Women over the age of 50 have the greatest risk for developing osteoporosis, but the disease can strike at any age. It is important to remember that the disease is not limited to women. One in eight men over the age of 50 are at risk for developing osteoporosis. Other risk factors include:
- Family history of osteoporosis
- Being thin or "small-boned"
- Caucasian or Asian race (although African Americans and Hispanic Americans are at risk as well)
- Early menopause (before age 45) or surgically induced menopause
- Nulliparity (never having children)
- Amenorrhea in pre-menopausal women (absence of regular menstrual periods)
- Eating a diet low in calcium or Vitamin D
- Low testosterone levels in men
- Inactive lifestyle
- Excessive caffeine, protein, or sodium intake
- Smoking
- Excessive alcohol use
- Having certain diseases such as asthma, lung disease, intestinal problems, kidney problems, hormonal problems, kidney stones, liver disease, primary hyperparathyroidism, rheumatoid arthritis, diabetes, anorexia nervosa, or bulimia
- Being an organ transplant recipient
- Use of certain medicines such as corticosteroids and anticonvulsants
What can you do to prevent osteoporosis?
- Eat a balanced diet rich in calcium and Vitamin D.
- Exercise regularly.
- Maintain a healthy lifestyle.
- Prevent falls (for example, by removing loose wires, cords, and rugs around your house; wearing sturdy rubber-soled shoes; installing grab bars in your tub or shower) so you can stay active.
Who should get tested for osteoporosis?
An initial examination for osteoporosis is recommended at menopause if you have risk factors. This assessment will alert you to any problems and allow doctors to prescribe treatments to curb bone loss and monitor your progress as you grow older. All women over the age of 65 and men with risk factors should have a bone density test.
Dual energy X-ray absorptiometry (DEXA)
The most accurate test available for detecting osteoporosis and other bone diseases is dual-energy X-ray absorptiometry (DEXA). This test, which takes about 10 to 15 minutes, measures the bone loss in your hips and spine. It also helps your doctor determine how quickly you are losing bone mass, as well as predict your risk of fracture. The test is also used to follow the course of the disease and monitor the effects of various treatments.
Before your DEXA test
You do not have to change your daily routine before this test. Eat, drink, and take your medicines you normally would. However, do not take calcium supplements (such as Tums) for 24 hours before your bone densitometry test. If you think you might be pregnant, notify your doctor.
During the test
You must wear a hospital gown, and you will be asked to lie on your back while the technologist performs the test. No needles or injections are involved. The DEXA procedure is similar to having a standard X-ray. The amount of radiation used is very small.
After the test
Generally, you can resume your usual activities immediately. The results of your test will be reviewed by a specially trained technologist and board-certified doctors. Your test results will be provided to your doctor, who will discuss the results with you.
Other information
Retail stores sometimes sell a smaller version of the DEXA machine that measure bone mass in your forearm. However, these readings do not reflect the bone loss in your hips and spine, where the most common debilitating fractures occur. Medicare now covers bone density testing for many patients, as required in the Bone Mass Measurement Act of 1998.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 1/5/2007
