Osteoporosis FAQ

Find answers on the most common questions people have about osteoporosis with the following list of FAQs.

My hip hurts. Isn’t that osteoporosis?

No. Osteoporosis causes broken bones so there is no pain until a bone fractures.

What’s the difference between osteoporosis and osteoarthritis?

Osteoarthritis is the joint disease when the joint surface disappears and leads to a grinding, painful joint. Osteoporosis is a bone disease with “porous” or thin bones that are low in calcium and snap like brown twigs.

So what is the big deal about osteoporosis?

Osteoporosis is very common in women after age 60 and 50% get a spine fracture and 30% have a hip fracture. The spine can develop a big hump from the fractures. The hip fracture leads to surgery and often prolonged nursing home care. Complications from surgery are common and death may occur. Younger people may have osteoporosis but the real risk for fractures is after age 60.

How do you get osteoporosis?

Your bones are a reflection of your genes, age, gender, and entire life so it can be very complicated. For most, age and a family tendency are the most common factors. Women never quite have the same level of calcium as men and may lose a lot for the 5 years after menopause. Bone loss occurs in men and women after age 40 but more so in women. With age, the bones snap and break instead of bending.

I heard there are other ways to get a weak skeleton. Is that right?

Yes. There is a long list of things like not eating calcium while growing up, being low in Vitamin D, taking oral cortisone-like medications, seizure medications, DepoProvera, early menopause, endocrine problems like too much parathyroid hormone, kidneys which leak too much calcium, GI absorption problems, prolonged bedrest, and so forth. It would be a good idea to be checked for these if you are in the lowest 10% of bone density for your age.

How do you know if you have osteoporosis?

It’s easy. Get a “bone density test” or BMD. The best one is when the spine and hip are measured.

Is the BMD test painful or dangerous?

No, unless just lying on a table bothers you. The radiation is negligible.

Does it matter where you get the BMD test?

Yes, if there needs to be followup tests in the future or “serial studies”. To do these accurately, the location has to be sure to use the same machine and verify the accuracy of their technique which is not being done in most places. It is at the Arthritis and Osteoporosis Center which has been performing this test since 1986. The need for repeated bone density testing should be individualized to your needs and circumstances, which help determine whether you need additional medication beyond calcium and Vitamin D to help protect your bones.

Won’t just taking calcium protect me from osteoporosis?

Sorry, this applies mostly to kids. Most adults get reasonable amounts in the diet and taking calcium does not build bone up, only make a bad situation from getting worse. Exceptions make be those who have totally avoided dairy products.

I heard something about the sun and Vitamin D.

Vitamin D is needed to absorb calcium and maintain bone. Many adults are very low in Vitamin D since they avoid the sun’s radiation in the summer which causes the skin to make Vitamin D. Some also may not absorb it from diet or supplements. A lot may needs to be learned about Vitamin D and osteoporosis. Being low also may lead to muscle pain and weakness.

Okay, if I have to use a prescription medication, what are the options?

Today, most of the recommendations for treatment of osteoporosis and osteopenia look at the costs as well as the side effects of therapy and balance that risk with the potential benefit of preventing fragility fractures. This risk benefit analysis is well defined for generic therapies, but the relationship between benefit and risk is not so well defined from an economic standpoint, with the more expensive trade name therapies that are continuing to be developed.

The most popular therapies are bisphosphonates, which includes generic Fosamax (Alendronate), generic Reclast (Zoledronic Acid), and generic Actonel (Risedronate). These medications are used only for a finite amount of time, usually between three and six years. Trade name medications like Evista, Forteo, and Prolia have slightly different mechanisms of action and may be appropriate in individual cases.

Being on the right treatment is critical, because we can prevent more than 50% of all fragility fractures with the right treatment. Get the proper help and make sure you are protecting your skeleton if you are at risk.