By: Au-Co Nguyen, DO, Geriatric Medicine, MemorialCare Medical Group – Huntington Beach (Beach Blvd.)
Osteoporosis is a condition that weakens bones, making them brittle and more prone to fractures— even from simple actions like bending over or coughing. While anyone can develop osteoporosis, it’s particularly common in older women. Osteoporosis is often considered a silent disease because people who develop it may not notice changes until a fracture occurs.
According to the National Institute on Aging, osteoporosis affects about one in five women over age 50, but only one in 20 men. Among women, those of White and Asian descent are more likely to develop osteoporosis. Women are at higher risk for osteoporosis because of postmenopausal bone loss, which is related to loss of estrogen, and tend to have thinner frames.
Potential Risk Factors for Osteoporosis
• Advanced age or early menopause: Bone density decreases naturally with age, making older adults, particularly women post-menopause, more susceptible to osteoporosis. Early menopause, whether due to surgery or other causes, can also accelerate bone loss.
• Family history or personal history of bone fractures: Genetics play a significant role in bone health. If a parent or sibling has osteoporosis or has suffered a fracture, there is a higher risk of developing the condition. Additionally, a personal history of fractures as an adult may indicate a weakened skeletal structure.
• Low body weight: Individuals with a low body mass index (BMI) are at a higher risk for osteoporosis because they have less bone mass to draw from as they age. This is especially true for women with small, thin frames.
• Poor dietary habits: A diet low in calcium and protein — two nutrients essential for strong bones — can contribute to bone loss. Calcium is crucial for bone formation and maintenance, while protein supports the structure and function of the bones.
• Lack of exercise or prolonged bed rest: Weight-bearing exercises, such as walking or strength training, stimulate bone growth and help maintain bone density. An inactive lifestyle or extended periods of bed rest (such as following surgery or illness) can weaken bones, increasing the risk of osteoporosis.
• Heavy alcohol and tobacco use: Excessive alcohol consumption can interfere with the body’s ability to absorb calcium, weakening bones over time. Smoking also contributes to bone loss by reducing the blood supply to bones, impairing the function of osteoblasts (cells responsible for bone formation), and lowering estrogen levels in women, all of which accelerate bone loss.
• Long-term corticosteroid use: Corticosteroid medicines such as cortisone, hydrocortisone, and prednisone are used to treat rashes, inflammatory bowel disease, asthma, and other conditions. However, corticosteroids may also have side effects, including an increased risk of osteoporosis.
Addressing these risk factors through diet, exercise, and lifestyle changes can help reduce the risk of developing osteoporosis or slow its progression. It’s essential to consult with a healthcare provider if risk for osteoporosis is suspected.
For women with osteoporosis, lifelong management is necessary through medication and lifestyle changes.
Osteoporosis related breaks primarily occur in the hip, wrist or spine and the risk for women increases greatly following menopause, with the decrease in bone-protecting estrogen. One in two women over the age of 50 have osteoporosis, yet nearly 80 percent remain undiagnosed because symptoms do not occur until most of their bone strength is lost.
Common Osteoporosis Symptoms
• Backache: One of the earliest signs of osteoporosis can be chronic back pain, which results from tiny fractures or collapsed vertebrae due to bone weakness.
• Gradual loss of height and a stooped posture: As bones in the spine weaken and compress, individuals may lose height over time and develop a hunched or stooped posture, known as kyphosis.
• Fractures of the spine, wrist, or hip: Fractures caused by osteoporosis can happen suddenly, often from minor falls or even routine activities like bending or lifting. These fractures are most common in the spine, wrist, and hip, which bear much of the body’s weight.
For those experience any of these symptoms it is important to speak to a primary care physician to talk about next steps and some potential screening options.
If the doctor recommends a bone density test to assess risk and determine the best treatment options, there are often bone density screening tests available at the same time as women complete their mammogram.
Are there Tests to Diagnose Osteoporosis?
The MemorialCare Breast Center – Long Beach, offers the Dual Energy X-ray Absorptiometry (DEXA) Test, a bone density scan that uses low-dose X-rays to measure bone strength and density.
A bone density scan begins with the patient lying on a specialized X-ray table while a radiologic technologist positions their body. Foam blocks may be placed under or around the patient’s legs to ensure proper positioning. Once positioned, the technologist passes a scanning arm over the body to capture images of the bones. Typically, scans focus on the hips and spine, though other bones, such as the forearms, may also be examined.
The bone density scanner uses two types of low-level radiation to create images and graphs that display bone density on a computer. Bones appear white in the images, while fat, muscle, and other soft tissue appear as dark shadows in the background.
A DEXA scan helps determine the most appropriate treatment of osteoporosis or early signs of the condition are present. This painless and non-invasive test allows doctors to assess bone density and evaluate the risk of fractures.
DEXA compares an individual’s Bone Mineral Density (BMD) to that of both their age group and young adults at peak bone strength. This information, along with other risk factors, helps physicians assess the likelihood of osteoporotic fractures. Additionally, DEXA scans are useful for tracking bone density changes over time, allowing healthcare providers to monitor the effects of aging, diet, medications, and treatments.
Using these test results, patients and their doctors can develop an effective treatment plan to maintain strong and healthy bones.
Can Osteoporosis Be Reversed?
While osteoporosis cannot be fully reversed, certain lifestyle changes and medical treatments can slow its progression and improve bone health.
1. Nutrition and Supplements: Adequate calcium and vitamin D intake is essential for maintaining bone density. While supplements can help, it’s best to get these nutrients from food sources such as:- Calcium: Sardines, tofu, dairy products- Vitamin D: Trout, salmon, mushrooms, and limited sun exposure
2. Regular Exercise: Weight-bearing and resistance exercises stimulate bone growth and slow bone loss. These activities also strengthen muscles and improve balance, reducing the risk of falls. Recommended exercises include:- Walking or jogging- Climbing stairs- Weightlifting- Bodyweight exercises
3. Lifestyle Changes: Avoiding smoking and excessive alcohol consumption is linked to stronger bones and a lower risk of fractures. These lifestyle changes also contribute to overall health and reduce the risk of other chronic conditions.
4. Medications to Prevent Bone Loss: Doctors prescribe various medications to strengthen bones and reduce the risk of fractures.
Should these more conservative methods not help any longer, or severity of osteoporosis worsens, patients may need more advanced treatment and therapy.
Comprehensive Osteoporosis Treatment and Advanced Surgical Care
For women at high risk for osteoporosis, especially perimenopausal women with low bone density and other risk factors, hormone-related therapy may be recommended to further prevent bone loss. For women with osteoporosis — particularly those over 65 or with a history of fractures — the primary goal of therapy is to prevent new fractures. This is achieved through a combination of therapeutic treatments, strategies to reduce fall risk, and medications that either slow bone breakdown or accelerate bone formation.
At MemorialCare Long Beach Medical Center, the care team takes an individualized approach to osteoporosis care, working closely with the patient to determine the best treatment plan. For many, that journey begins with a primary care provider like me, where I specialize in helping older adults at MemorialCare Medical Group – Huntington Beach (Beach Blvd.) stay ahead of bone loss through early screening, lifestyle recommendations, and medication management.
When osteoporosis progresses and requires more advanced intervention, our orthopedic specialists may recommend rehabilitation through physical therapy, medications, or surgical solutions. For severe fractures, surgical procedures are performed to reposition and secure bone fragments. In the case of hip fractures, total or partial hip replacement may be necessary to restore mobility and improve quality of life.
From prevention to surgical care, MemorialCare provides a full spectrum of osteoporosis support. Schedule an appointment online with your primary care physician or call (877) 696-3622.
