Your Risk for Osteoporosis and Bone Fractures

When Pam Roe, 66, went to her doctors a few years ago with back pain, they told her she had a vertebral fracture. But they also discovered the hidden cause behind her cracked backbone: osteoporosis.

Although osteoporosis runs in her family, Roe says she found out her diagnosis was likely also caused by medication she was taking. "I had been on a very high dose of prednisone for almost 2 years to treat an autoimmune disease," she says. Those steroid treatments, along with her age, gender, and family history, put Roe at high risk of getting the disease -- and breaking bones.

Who Gets It and Why

Osteoporosis happens when your body starts losing bone, doesn't make enough bone, or both. It causes weak bones that break easily, especially after a fall.

"There's often nothing wrong with the bone -- there's just too little of it," says Susan L. Greenspan, MD, director of the Osteoporosis Prevention and Treatment Center and the Bone Health Program at the University of Pittsburgh Medical Center. "Imagine a stool that only has two legs instead of four. It's much easier to break."

You lose bone as you age, so the older you are, the more likely you are to get osteoporosis, especially if you're a woman. "After age 50, one out of every two women and one out of five men will fracture a bone," Greenspan says.

And once you've broken a bone, you're much more likely to break another one in the future. Roe's fractures didn't stop with her broken vertebrae. "I've had another vertebral fracture, a hip broken in two places, and broken bones in my hand and both feet," she says.

Besides your age, gender, and past broken bones, there are other things that raise your risk of getting osteoporosis, like:
 

  • Family history of the disease, or a mother or father with a hip fracture
  • Conditions like overactive thyroid condition, rheumatoid arthritis, diabetes, lung diseases, and Parkinson's disease
  • Medications like steroids, heartburn medicine, seizure drugs, or breast and prostate cancer medications
  • Early menopause
  • Lack of exercise
  • Too thin
  • Not enough calcium or vitamin D
  • Don't eat enough fruits and veggies
  • Smoking
  • Have too much protein, sodium, caffeine, or alcohol

Even if one or more of these things are true for you, it doesn't mean you'll get the disease. But it does mean you should keep a close eye on your bone health and take steps to keep your bones strong.

"The good news is there are lifestyle changes and medications that reduce the risk of fractures and keep you active and standing tall," Greenspan says.

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How to Check Your Bone Health

Your doctor has several tools to help monitor how your bones are doing. In addition to your medical history and an exam, she can also use certain tests to measure the density of your bones. Most commonly, doctors use a bone density test, or DEXA.

"The bone density lets the health care provider know if the bone is normal, on the way to osteoporosis, or osteoporotic," Greenspan says. "It's easy, comfortable, and low radiation."

Doctors recommend regular bone density scans for women starting at age 65, and for men starting at age 70. Or you may have one sooner if you have things that may raise your chances of osteoporosis, such as:

  • Breaking a bone after age 50
  • Back pain
  • Height loss of 1/2 inch in a year
  • Height loss of 1 and 1/2 inches from your original height

If you're on medication for osteoporosis, your doctor will likely recommend you have a bone density test every 1 to 2 years.

Once your doctor has your bone density information, she can use it to do an osteoporosis risk assessment test, or FRAX. The test scores can help you learn how likely it is you'll break a bone in the next 10 years.

WebMD Feature Reviewed by Brunilda Nazario, MD on May 23, 2018

Sources

SOURCES:

Pam Roe, Atlanta.

Medscape: "Steroid-induced Osteoporosis."

Susan L. Greenspan, MD, professor of medicine, University of Pittsburgh; director, Osteoporosis Prevention and Treatment Center and Bone Health Program, University of Pittsburgh Medical Center.

American Academy of Orthopaedic Surgeons: "Osteoporosis and Spinal Fractures," "Osteoporosis."

National Osteoporosis Foundation: "Are You At Risk?" "Bone Density Exam/Testing," "Risk Assessment (FRAX)."

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