Osteoporosis

What is osteoporosis?

From: MedlinePlus, National Library of Medicine

Osteoporosis is a disease in which your bones become weak and are likely to fracture (break). The disease can develop when your bone mineral density and bone mass decrease. It can also happen if the structure and strength of your bones change.

Osteoporosis is called a "silent" disease because it doesn't usually cause symptoms. You may not even know you have the disease until you break a bone. This could happen with any bone, but it's most common in the bones of your hip, vertebrae in the spine, and wrist.

What causes osteoporosis?

From: MedlinePlus, National Library of Medicine

Your bones are made of living tissue. To keep them strong, your body breaks down old bone and replaces it with new bone. Osteoporosis develops when more bone is broken down than replaced. You lose bone mass and changes happen in the structure of your bone tissue. This can happen as you get older. Other risk factors can also lead to the development of osteoporosis or increase your chance of developing the disease.

Who is more likely to develop osteoporosis?

From: MedlinePlus, National Library of Medicine

Anyone can develop osteoporosis, but you are more likely to develop it if you have one or more risk factors:

• Your sex. Osteoporosis is more common in women, especially after menopause (postmenopausal).
• Your age. Your risk increases as you get older. It is most common in people over age 50.
• Your body size. It is more common in people who are slim and thin boned.
• Your race: White and Asian women are at highest risk. African American and Mexican American women have a lower risk. White men are at higher risk than African American and Mexican American men.
• Family history. Your risk of osteoporosis may be higher if one of your parents has osteoporosis or broke their hip.
• Changes to hormones. Low levels of certain hormones can increase your chance of developing osteoporosis.
• Diet. A diet that is low in calcium and/or vitamin D or does not include enough protein can raise your risk.
• Long-term use of certain medicines, such as: Corticosteroids Proton pump inhibitors (which treat GERD) Medicines to treat epilepsy
• Having other medical conditions, such as: Endocrine diseases Certain digestive diseases Rheumatoid arthritis Certain types of cancer HIV Anorexia nervosa, a type of eating disorder
• Your lifestyle. Certain lifestyle factors can contribute to bone loss, such as: Smoking tobacco Long-term heavy alcohol use Physical inactivity or prolonged periods of bedrest

What are the symptoms of osteoporosis?

From: MedlinePlus, National Library of Medicine

Osteoporosis usually doesn't cause symptoms. You may not know that you have it until you break a bone.

How is osteoporosis diagnosed?

From: MedlinePlus, National Library of Medicine

Health care providers often diagnose osteoporosis during routine screening for the disease. The U.S. Preventive Services Task Force recommends screening for:

For men, it isn't clear yet whether regular screening is helpful. More research is needed to know for sure.

To find out if you have osteoporosis, your provider:

• Women age 65 and older
• Postmenopausal women under age 65 who have factors that increase the chance of developing osteoporosis
• Will ask about your medical history and whether you have ever broken a bone
• May do a physical exam, which could include checking for: A loss of height and/or weight Changes in your posture Balance and gait (the way you walk) Your muscle strength
• Will likely order a bone density scan
• May do a fracture risk assessment, which is a short questionnaire that helps estimate your risk of breaking a bone in the next 10 years
• Will likely order a bone density scan
• May do a fracture risk assessment, which is a short questionnaire that helps estimate your risk of breaking a bone in the next 10 years

What are the treatments for osteoporosis?

From: MedlinePlus, National Library of Medicine

The goals for treating osteoporosis are to slow or stop bone loss and to prevent fractures. Your provider may recommend:

In addition to managing your osteoporosis, it's important to avoid activities that may cause a fracture. These can include movements that involve:

You can also help reduce the risk of breaking a bone by preventing falls.

• A healthy, balanced diet that includes enough calcium, vitamin D, and protein
• Lifestyle changes such as quitting smoking and limiting alcohol
• Regular physical activity including weight-bearing exercise (like walking), strength training, and balance exercises
• Fall prevention to help prevent fractures
• Medicines, such as: Medicines that slow down bone loss Medicines that help rebuild bone
• Twisting your spine, like swinging a golf club
• Bending forward from the waist, like sit ups and toe touches

Can osteoporosis be prevented?

From: MedlinePlus, National Library of Medicine

To help keep bones strong and help prevent osteoporosis, the best thing to do is to eat a healthy diet rich in calcium and vitamin D. Getting regular physical activity, limiting alcohol, and not smoking can also help.

Which doctor should you see?

The suggested department for discussing Osteoporosis is Orthopaedics, with a orthopaedic specialist as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• What explains the change in pain, movement or function?
• Which activities need adjustment while the diagnosis is being clarified?
• What are the roles of rehabilitation, observation and surgery in this situation?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.