Osteoporosis is a disease that causes bones to become weak and brittle. In osteoporosis, bones may fracture easily, causing chronic pain, deformity, and loss of height and mobility.
What is osteoporosis?
Throughout life, bones are constantly remodeled – broken down and rebuilt. When we are young, we tend to build bone at a faster rate. Our bones are densest around age 30. As we age, lowered hormone levels and other changes slow the rate of bone formation, and we lose bone faster than we build it. Osteoporosis makes bones less dense and more porous and delicate. A fall, even a cough or a sneeze, may be enough to cause a fracture in someone with advanced osteoporosis.
While some bone loss is normal with age, inherited genes, environmental factors such as diet, smoking, and certain medications and health conditions can raise the risk for some people developing osteoporosis.
Read more about causes of osteoporosis.
The history of osteoporosis
Throughout most of history, weak bones and bone fractures from osteoporosis were assumed to be a normal biological part of aging, like greying hair and wrinkles. Physicians noticed that women were more likely to experience bone fractures, but they did not identify the reason for this risk factor. For example, when a pair of German doctors observed elderly patients in 1882, they suggested that “women tripping over their long skirts” caused osteoporotic bone fractures.
Osteoporosis is Greek for "porous bones." The term osteoporosis was first coined by American physician Fuller Albright, who described osteoporosis as a postmenopausal hormonal deficiency. In 1942, Albright led a team of researchers in testing estrogen hormone replacement therapy in women with osteoporosis. Estrogen showed a slight improvement in strengthening bones, but researchers concluded that osteoporosis is irreversible.
In 1980, British doctor B. E. Christopher Nordin began to study the role of calcium in osteoporosis. He found that calcium, like estrogen therapy, offered a slight improvement in strengthening osteoporotic bones, but could not reverse osteoporosis. This led Nordin to develop ways to quantify bone density, giving rise to the field of bone densitometry. To measure bone mass density (BMD), Nordin used the healthy bone status of young adults as the standard against which bone density is measured. The risk of fracture increases when bone density falls below that standard. This approach revolutionized osteoporosis study and accelerated researchers to find the missing puzzle piece – how to keep bone density from falling in the first place. From here, Nordin and others were able to prove the benefits of calcium, vitamin D, and estrogen therapy to prevent osteoporosis. Today doctors and researchers are prioritizing osteoporosis prevention as a worldwide health initiative.
In the 21st century, researchers launched a new era of treatments that can lower the risk for fracture in people with osteoporosis. Bisphosphonates such as Alendronate and Risedronate, the hormone Calcitonin, and the newer biologic drug Prolia (Denosumab) were found to help prevent the breakdown of bone and preserve bone density. Hormone-based treatments Forteo (Teriparatide) and Tymlos (Abaloparatide) stimulate the body to build up the bones. Many new treatments for osteoporosis are in the development pipeline today.
How common is osteoporosis?
Osteoporosis is extremely common, especially in people over 50. Approximately half of women and one quarter of men over 50 are estimated to have osteoporosis, putting them at risk for fractures.
Some diseases and medications can cause osteoporosis to develop in younger people. Read more about types of osteoporosis.
How does osteoporosis progress?
Osteoporosis is progressive, causing bone loss gradually over time. When bone loss begins, it is usually “silent” and may not cause any symptoms for years. Most people do not realize they have osteoporosis until their first fracture.
Can you die from osteoporosis?
Osteoporosis is not a fatal condition. Most people with osteoporosis life a normal lifespan and die of the same things most people die of: heart disease, cancer, lung disease, Alzheimer’s, etc. However, some studies indicate that fractures – especially hip fractures – caused by osteoporosis can contribute to a shortened life expectancy. Evidence shows that treating osteoporosis lowers the risk of a shortened life span.
How is osteoporosis diagnosed?
Doctors diagnose osteoporosis by scanning your bones to measure bone mineral density. The most common type of scan to measure bone mineral density is dual-energy X-ray absorptiometry, or DXA.
Learn more about the process of diagnosing osteoporosis.
What are the symptoms of osteoporosis?
Osteoporosis does not usually cause any symptoms before the first fracture occurs. Fractures can lead to chronic pain, loss of height, posture deformity, and mobility problems.
Learn more about osteoporosis symptoms.
How is osteoporosis treated?
There are several classes of medications that work by preventing the breakdown of bone and encouraging the formation of new bone. Good nutrition, exercise, and supplementation with calcium and vitamin D can help support healthy bones. Spinal surgery can help some people with spinal fractures due to osteoporosis.
Learn more about osteoporosis treatments.