Osteoporosis

Having osteoporosis means your bone mass and strength is less than it used to be. And this can put you at risk for sudden and unexpected fractures.

It often develops without symptoms or pain. So, you may not know you have it until you get a fracture. Osteoporosis can cause any bone to break but most often happens in your hips, wrists and spine.

If you’re having symptoms, you may notice you’ve lost height. And you may have back pain. Or you might have a health condition that increases your risk for osteoporosis. Some are menopause, eating disorders, gastrointestinal conditions, hormone problems and autoimmune conditions. Some medications can also cause brittle bones.

What to expect at your first visit.

At your first visit, you’ll want to be ready to talk about any symptoms you have. Your provider will want to know what your symptoms are and how long you’ve had them. They’ll also ask:

• What do you usually eat?
• How often do you exercise?
• Do you sit a lot during the day?
• Do you smoke?
• Do you drink alcohol? And if so, how much?
• What medications do you take?
• Have you been diagnosed with other health conditions?
• Have you had any fractures?
• Does anyone in your family have osteoporosis?

If you were assigned female at birth (AFAB), your provider will also go over your menstrual history with you.

During this visit, you’ll also get a physical exam. Your provider will check your height and weight, posture, balance, gait (the way you walk) and overall strength and health.

Your provider will also order a bone density test to measure your bone strength. This test uses X-rays to see how much calcium and other minerals are in your bones. This test is also sometimes called a DEXA or DXA scan.

This test is the best way to catch osteoporosis before you break a bone. And it’s usually more reliable for osteoporosis diagnoses than regular X-rays. Those only show osteoporosis when it’s progressed.

You may also have a thoracic spine X-ray so we can check compression fractures in your vertebrae. This test is important if you’ve noticed you’ve lost height.

Meet Our Osteoporosis Team

When you choose Cleveland Clinic, you can take comfort in knowing you have a strong care team on your side, with providers like:

• Rheumatologists.
• Radiologists.
• Physical therapists.
• Endocrinologists.
• Gastroenterologists.
• Gynecologists (for people assigned female at birth).

We select your provider based on your unique needs. This lets us provide you with the most personalized treatment for the best possible results.

Your care team uses the results of your physical exam and tests to pinpoint your fracture risk. And they craft a care plan to best address this risk — and what’s causing your osteoporosis. 

Your treatment plan focuses on helping you manage your condition so you can improve your quality of life. And avoid fractures. Treatments may include lifestyle changes, exercise, physical therapy and medications.

Good habits for bone health

We’ll help you make lifestyle changes to improve your bone health. This can include eating more nutritious food, quitting smoking, seeing a physical therapist and more. We focus on what’s right for your health. Early in your treatment, we’ll:

• Counsel you on nutrition and supplements to support bone health.
• Teach you how to read food labels and track your calcium and vitamin D intake (which helps strengthen bones).
• Show you exercises to improve your balance, strengthen your core and increase bone density.
• Go over ways to prevent falls.
• Offer assistive devices like a walker, when needed.
• Help you stop smoking.

Osteoporosis medications

We might also recommend you take medications to increase bone density, prevent bone loss or build new bone. You may take:

• Hormone-related therapies like replacement estrogen, testosterone or bisphosphonates.
• Parathyroid hormone analogs to control calcium levels in your blood.
• Drugs to slow bone breakdown like denosumab injections (Prolia^®, XGEVA^®).
• Medications that help build bone, like romosozumab injections (EVENITY^®).

Living With Osteoporosis

Osteoporosis requires lifelong management. You’ll have regular in-person follow-ups and virtual visits with your providers. And you’ll have testing usually once or twice a year. We do this to make sure your treatment is working. And if it isn’t, we can quickly update your treatment plan.

You’ll also want to be sure to exercise regularly. And make sure you get enough calcium and vitamin D. To avoid fractures, it’s important to keep your home free of clutter that can trip you. And avoid things that increase your fall risk — like standing on a table or chair to reach things.

Taking the Next Step

Osteoporosis doesn’t have to slow you down. Our healthcare providers are here to support you and help you feel more confident about moving through life after your diagnosis. We work to help you slow your bone loss, avoid bone fractures and stay independent — so you can keep living life to the fullest.