Osteoporosis is a bone disease which causes your bones to become weak and brittle. Osteoporosis can be caused by gradual bone loss over time, or more rapid bone loss secondary to medications or underlying diseases. Weakened bones are more likely to “break” or “fracture” following a low trauma accident. This is most often a fall from a standing height at a walking speed, but it can be as minimal as a cough or sneeze in advanced stages of the disease.
Osteoporosis is a common disease that affects millions of people of all ages, genders, and ethnicities throughout the world.
Osteoporosis can be classified in two ways – based on the type of osteoporosis that you have, and based on the severity of your disease.
Three types of osteoporosis have been identified.
Type 1 primary osteoporosis is also known as postmenopausal osteoporosis. It affects women following menopause and is caused by a sudden loss of the hormone estrogen. Women can lose more than 10% of their bone density during menopause, which makes women more likely to develop osteoporosis at a younger age compared to men.
Type 2 primary osteoporosis is also known as age-related osteoporosis. It affects both men and women over age 70 and is caused by a gradual loss of bone density over an extended period of time due to old age.
Secondary osteoporosis is caused by an underlying disease or use of a medication known to weaken your bones. This form of osteoporosis can impact men and women of all ages. It has been reported that up to 75% of men and 30-50% of women have a secondary cause to their osteoporosis.
The second way to classify osteoporosis is based on how severely your bones are impacted by the disease. A specialized x-ray of your hips, spine, or forearm using a DEXA bone density scanner can provide this useful information. More information about DEXA scans can be found on the osteoporosis screening page.
The medical community has created the following cut-offs for determining if your bone density is normal, mild to moderately low (osteopenia), or severely low (osteoporosis).
Once your bones have been properly classified based on the type and severity of the disease, you should discuss with your medical provider which treatment options are best for you.
Osteoporosis is a silent disease – meaning that if you have osteoporosis, you will not necessarily have any physical symptoms. Many people have remained completely oblivious to the disease for years because the body rarely sends any physical clues. Unfortunately, if osteoporosis is not diagnosed through routine screenings, the first symptom is often a broken bone following a low trauma injury. When symptoms do develop, they tend to be one of the following:
If you break a bone after age 50 or have any concerns about your bone health, you should ask your medical provider to be screened for osteoporosis today!
A fragility fracture is defined as a broken bone that occurs from a low trauma injury that we would not expect to lead to a fracture in a person with healthy, strong bones. It is best to think of fragility fractures as a warning cry from your bones alerting you to the possibility of osteoporosis. These injuries should never be ignored… they are a call to action! Everyone should be screened for osteoporosis following this type of fracture so that you can begin improving your bone health immediately.
So how do you know if your fracture is concerning for osteoporosis? It isn’t an exact science, but these three guidelines can help us identify fragility fractures.
The concept of a fragility fracture can be confusing for many. Admittedly, even in the medical community we do not always agree on exactly which fractures meet this classification. I follow this simple rule of thumb—when in doubt, it is always better to have your medical provider run the appropriate tests necessary to evaluate your bones for osteoporosis than to get hung up on whether your injury was a “fragility fracture” or not.
Let’s take a look at two scenarios to better illustrate what qualifies as a fragility fracture.
