Healthy bones are an important part of your overall well-being. Your bones are not just your body’s frame. They also protect your organs, support your muscles, store calcium and help you move. When they aren’t at their best, your health may be at risk.
Certain diseases or problems can weaken or damage your bones. Here’s what to know about some of the most common ones.
Your bone tissue is constantly breaking down and being replaced. During childhood, new bone growth outpaces old bone breakdown, and your bones get bigger and stronger. After about age 20, this process starts to even out for both men and women. By age 40, your bones can start to lose their strength. Low bone density increases your risk of wrist, spine and hip fractures. Other bones can also be affected.
Osteopenia is a condition that can lead to the bone disease known as osteoporosis. With osteopenia, your bone density is lower than average but not low enough to be classified as osteoporosis. At this stage, there are still steps you can take to lower your chances of developing osteoporosis.
Most people don’t notice osteoporosis symptoms until it is advanced. At that point, you could have:
There are risk factors for developing osteopenia and osteoporosis that you can’t control. Your risk is higher if you:
The good news is that there are steps you can take to lower your risk of developing osteoporosis.
Good bone health starts early, so if you have children encourage them to be physically active and to choose a calcium-rich diet. From birth until about age 20, children can continue to build bone strength. After that, you can take easy steps to keep your bones strong.
With the right choices, you can maintain the strength of your bones so they support you for life. Here are some tips:
Because most people don’t have symptoms of osteopenia or osteoporosis, it’s very important to ask about bone density screening as early as age 50 if you are at risk. When these conditions are detected early, you can consider treatment options to help keep them from progressing.
Talk to your doctor if you think you may be at risk, especially if you went through menopause early, have taken steroids for several months at a time or have a parent or sibling who had osteopenia, osteoporosis or a hip fracture.
Your doctor may test your blood and urine to look for conditions that can cause loss of bone mass. They will also probably recommend a Dual-Energy X-ray Absorptiometry (DEXA or DXA) scan, also called a bone mineral density scan. This test is a common and reliable way to measure bone density and assess bone health. It’s recommended for anyone at high risk, all women over age 65 and all men over age 70.
DXA scans are painless, non-invasive and take less than 30 minutes. For the test, you lie on a table and have low-dose X-rays taken of your hip or spine.
Your DXA scan will result in a T-score , which compares your bone density to a healthy 30-year-old. A score of -1 or above is normal. A score between -1 to -2.5 means you have osteopenia. A score equal to or lower than -2.5 means you have osteoporosis. If you have osteoporosis, your doctor will probably want you to have DXA scans every two years to monitor your bone loss.
For pre-menopausal women, men under age 50 and children, a race and ethnicity adjusted Z-score is used. Z-scores at or below -2.0 are considered low bone mineral density for their chronological age.
Treatment of osteopenia and osteoporosis is very important because when your bones get weaker, you’re at higher risk of a dangerous bone fracture. It can also take you longer to heal from a fracture, which may also limit your mobility for the rest of your life.
Your health care provider may recommend treating osteopenia with exercise, nutrition and vitamin or mineral supplements, which may help slow or stop the loss of bone density.
If you develop osteoporosis – and in some cases if you have osteopenia – prescription medication may be recommended. There are various options to consider for treating osteoporosis, including:
Your provider will work with you to develop a treatment plan and will want to monitor your bone density regularly to watch for changes. If treatments aren’t working or your osteoporosis is severe, your doctor might recommend a biologic called Denosumab (Prolia) or bone-strengthening medications such as teriparatide (Bonsity or Forteo), abaloparatide (Tymlos) or romosozumab (Evenity). However, aside from Prolia, you can only take these drugs for one to two years.
Some people try supplements like soy, black cohosh or red clover to treat osteoporosis, but there’s no evidence that they work. If you choose to try supplements, be sure to let your doctor know since they can interact with other medicines.
To stay safe, older adults should make sure their homes and pathways are well-lit, keep clutter off floors, use non-skid rugs, use handrails whenever they are available (such going up or down stairs, using the toilet or during bathing), and wear shoes that fit well and have non-slip soles.
Health care providers at Banner Health are also skilled in diagnosing and treating other bone conditions, including:
Along with DXA scans for bone density, other tests can evaluate your bone health. Depending on your symptoms, your doctor may recommend: