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Osteoarthritis

Osteoarthritis is the most common form of arthritis, the inflammation or swelling of one or more joints. More than 100 conditions affect the joints, tissues around the joint, and other connective tissues. Learn more about the different conditions.

 

Approximately half of women and a fourth of men over the age of 50 have osteoporosis,  and 1 in 3 people over 50 have reduced bone density (osteopenia), which can become osteoporosis. Most people don’t know they have osteoporosis until it causes them to break a bone. Osteoporosis occurs when the creation of new bone doesn't keep up with the loss of old bone.  Bones become so weak and brittle that a fall or mild stresses such as bending over or coughing can cause a break and serious consequences. Osteoporosis-related breaks most commonly occur in the hip, wrist, or spine.

 

Risk Factors

Use this Bone Health Assessment or review the many factors that can contribute to osteoporosis.  

  • Family history of hip fractures

  • Small body frame and lack of bone mass obtained in youth

  • White and Asian women, especially those past menopause or those who experienced early menopause.

  • Hormones: too much or too little of estrogen and testosterone, common in breast and prostate cancer treatments

  • Overactive thyroid or too much thyroid hormone medicine to treat an underactive thyroid

  • Overactive parathyroid and adrenal glands

  • Long-term use of corticosteroid medicines, such as prednisone and cortisone

  • Use of medications for seizures, gastric reflux, cancer, and transplant rejection

  • Medical problems such as celiac disease, inflammatory bowel disease, kidney or liver disease, cancer, multiple myeloma, and rheumatoid arthritis

  • Dietary factors such as low calcium intake, eating disorders, being underweight, and gastrointestinal surgery 

  • Lifestyle choices such as a sedentary lifestyle, excessive alcohol consumption, and tobacco use

Signs and Symptoms

There typically are no symptoms in the early stages of bone loss, but once weakened, the following can occur:

  • A broken or collapsed bone causes lower back pain in the spine.

  • Loss of height over time (an inch or more)

  • Changes in posture, such as stooping or bending forward

  • Shortness of breath due to compression of spinal disks 

  • A bone that breaks much more easily than expected

Diagnosis 

A healthcare provider will diagnose osteoporosis with a bone density test using X-rays to measure the calcium and other minerals in the bones to determine their strength.  

Prevention and Treatment to prevent bone loss or strengthen already weak bones

  • Calcium: People aged 18 to 50 need 1,000 milligrams of calcium a day, and 1,200 milligrams for women over  50 and men over 70. Total calcium intake from supplements and diet combined should be no more than 2,000 milligrams daily.  Good sources include low-fat dairy products, dark green leafy vegetables, canned salmon or sardines with bones, soy products, calcium-fortified cereals, and orange juice.

  • Vitamin D improves the body's ability to absorb calcium and improves bone health. People can get some of their vitamin D from sunlight. Dietary sources of vitamin D include cod liver oil, trout, salmon, and fortified milk and cereal. Most people need at least 600 international units (IU) of vitamin D daily and 800 IU daily after age 70.

  • Exercise can help build strong bones and slow bone loss. Combine strength training with weight-bearing and balance exercises. Strength training helps strengthen muscles and bones in the arms and upper spine. Weight-bearing exercises—such as walking, jogging, running, stair climbing, skipping rope, skiing, and impact-producing sports—affect mainly the bones in the legs, hips, and lower spine. Balance exercises such as tai chi can reduce the risk of falling.

  • Medications prescribed by healthcare providers. Some of the most common medications include hormone therapies. People with severe osteoporosis or a high risk of fractures might need medications, including parathyroid hormone (PTH) analogs, denosumab, and romosozumab. These medications are usually given as injections.

  • Fall Prevention Measures can reduce the chance of injury and breaking a bone.  Review these tips to lessen the risk of falls. 

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