Osteoporosis
Osteoporosis is a bone disease where density drops to the point that fractures can happen from minor falls—or in severe cases, from bending over or coughing. It affects around 10 million Americans, mostly postmenopausal women, though men develop it too. The disease is silent until a fracture happens. Hip fractures, vertebral compression fractures, and wrist fractures are the most common injuries orthopaedic surgeons treat as a result.
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Symptoms
- No symptoms in early stages—the first sign is often a fracture
- Back pain from a collapsed vertebra
- Gradual loss of height (an inch or more over time)
- Stooped posture or rounding of the upper back
- Fractures from minor falls or low-impact activities
- Bone tenderness in the spine or hips
When to See a Doctor
Get a bone density scan (DEXA) if you are a woman over 65, a man over 70, or younger with risk factors like prolonged steroid use, early menopause, or a parent who had a hip fracture. After any fragility fracture—a break caused by a fall from standing height—see a specialist right away.
Treatment Options
Calcium and vitamin D
The foundation of both prevention and treatment. Most adults with osteoporosis need 1,000–1,200 mg of calcium daily from food and supplements, plus 800–1,000 IU of vitamin D.
Bisphosphonate medications
Alendronate, risedronate, and zoledronic acid slow bone loss and reduce fracture risk. Taken as weekly pills or an annual IV infusion. Most patients take them for 3–5 years.
Anabolic medications
Teriparatide and romosozumab build new bone rather than just slowing loss. Reserved for very high fracture risk or when bisphosphonates fail. Given by injection daily or monthly.
Surgical fracture repair
Hip fractures almost always need surgery—pinning or replacement depending on the fracture type. Vertebral compression fractures may be treated with kyphoplasty, which injects bone cement to stabilize the vertebra and partially restore height.
Recovery Timeline
Medications improve bone density measurably within 1–2 years. Hip fracture surgery takes 3–6 months of recovery for most daily activities. Kyphoplasty recovery is much faster—many patients go home the same day with significant pain relief within days.
Frequently Asked Questions
Can osteoporosis be reversed?
Bone density loss cannot be fully reversed, but treatment can meaningfully increase density and reduce fracture risk. Anabolic medications like teriparatide build new bone and are the closest thing to reversal currently available. Most people on treatment see a significant reduction in fracture risk within 1–3 years.
How is osteoporosis diagnosed?
A DEXA scan measures bone mineral density and produces a T-score. A score of -2.5 or below means osteoporosis; between -1.0 and -2.5 is osteopenia (low bone mass). The scan takes about 10 minutes, no needles, and very low radiation.
What type of doctor treats osteoporosis?
Primary care doctors often manage osteoporosis medications. Orthopaedic surgeons treat the fractures osteoporosis causes—hip, vertebral, and wrist fractures. Endocrinologists and rheumatologists handle complex or treatment-resistant cases.
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This information is for educational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.