About osteopenia

What is osteopenia?

Osteopenia facts

  • Osteopenia is decreased bone density but not to the extent of osteoporosis. This decreased bone density leads to bone fragility and an increased chance of breaking a bone (fracture).
  • Women over the age of 65 and any postmenopausal woman with risk factors for bone loss should be tested for osteopenia or osteoporosis. The DXA scan is a widely available and accurate method for diagnosing osteopenia or osteoporosis.
  • Not everyone with osteopenia requires treatment with prescription medications; your doctor can determine if you should be treated based on your bone density and other risk factors.
  • An adequate intake of calcium and vitamin D, avoiding excessive alcohol, not smoking, and getting plenty of exercise can help prevent osteopenia.
  • While most people affected by osteopenia are women, men can also be affected by osteopenia and osteoporosis and should be evaluated for these bone conditions when they are considered to be at risk.

What is osteopenia?

Osteopenia is a bone condition characterized by a decreased density of bone, which leads to bone weakening and an increased risk of breaking a bone (fracture). Osteopenia and osteoporosis are related conditions. The difference between osteopenia and osteoporosis is that in osteopenia the bone loss is not as severe as in osteoporosis. That means someone with osteopenia is more likely to fracture a bone than someone with a normal bone density but is less likely to fracture a bone than someone with osteoporosis.

Osteomalacia, osteomyelitis, and osteoarthritis are different conditions that are frequently confused with osteopenia because they sound similar. Osteomalacia is a disorder of the mineralization of newly formed bone, which causes the bone to be weak and more prone to fracture. There are many causes of osteomalacia, including vitamin D deficiency and low blood phosphate levels. Osteomyelitis is bone infection. Osteoarthritis is joint inflammation featuring cartilage loss and is the most common type of arthritis. Osteoarthritis does not cause osteopenia, osteoporosis, or a decreased bone mineral density.

What are the symptoms for osteopenia?

Osteopenia doesn’t usually cause symptoms. Losing bone density doesn’t cause pain.

What are the causes for osteopenia?

Aging is the most common cause of osteopenia. After your bone mass peaks, your body breaks down old bone faster than it builds new bone. That means you lose some bone density.

Women lose bone more quickly after menopause, due to lower estrogen levels. If you lose too much, your bone mass may drop low enough to be considered osteopenia.

About half of Americans older than age 50 get osteopenia. The more of these risk factors you have, the higher your risk is:

  • being female
  • a family history of low BMD
  • being older than age 50
  • menopause before age 45
  • removal of ovaries before menopause
  • not getting enough exercise
  • a diet lacking calcium and vitamin D
  • smoking or using other forms of tobacco
  • drinking too much alcohol or caffeine
  • taking prednisone or phenytoin

What are the treatments for osteopenia?

The goal of treatment is to keep osteopenia from progressing into osteoporosis.

The first part of treatment involves diet and exercise choices. The risk of breaking a bone when you have osteopenia is fairly small, so doctors don’t usually prescribe medicine unless your BMD is close to the osteoporosis level.

Your healthcare professional might talk to you about taking a calcium or vitamin D supplement, although generally it’s better to get enough of each from your diet.

Osteopenia diet

To get enough calcium and vitamin D, eat dairy products such as cheese, milk, and yogurt. Some types of orange juice, breads, and cereals are fortified with calcium and vitamin D. Other foods with calcium include:

  • dried beans
  • broccoli
  • wild freshwater salmon
  • spinach

The goal for people with osteoporosis is 1,200 milligrams of calcium a day and 800 international units (IU) of vitamin D. However, it isn’t clear whether this is the same for osteopenia.

Osteopenia exercises

Walking, jumping, or running at least 30 minutes on most days will strengthen your bones if you have osteopenia, are a young adult, or are a premenopausal female.

These are all examples of weight-bearing exercises, which means you do them with your feet touching the ground. While swimming and biking may help your heart and build muscles, they don’t build bones.

Even small increases in BMD can significantly reduce your risk for fractures later in life.

However, as you get older, it becomes harder for you to build bone. With age, your exercise should emphasize muscle strengthening and balance as well.

Walking is still great, but now swimming and biking count, too. These exercises can help reduce your chances of falling.

Talk with your doctor about the best and safest exercises for you.

In addition to walking or other exercise, try these strengthening exercises:

Hip abductors

Hip abductors strengthen your hips and improve balance. Do this 2 to 3 times a week.

  1. Stand tall with your right side facing a chair, holding onto the back of the chair with right hand.
  2. Put left hand on top of your pelvis and raise left leg to the side, keeping it straight.
  3. Keep toe pointed forward. Don’t raise so high that your pelvis rises.
  4. Lower leg. Repeat 10 times.
  5. Change sides and do the same exercise 10 times with your right leg.

Toe and heel raises

Toe raises and heel raises strengthen lower legs and improve balance. Do them each day. Wear shoes for this exercise if you have pain in your feet.

  1. Stand tall facing the back of a chair. Lightly hold onto it with one or both hands to stay balanced. Work up to being able to stay balanced using just one hand or a few fingers.
  2. Keep heels on ground and lift toes off floor. Keep standing straight with knees straight.
  3. Hold for 5 seconds. Then lower toes.
  4. Now rise up on toes and hold for 5 seconds.
  5. Slowly lower heels back to the floor and repeat 10 times.

Prone leg lifts

Prone leg lifts strengthen your lower back and buttocks and stretch the front of your thighs. Do this exercise 2 to 3 times a week.

  1. Lie on your stomach on a mat on the floor or on a firm bed, with a pillow underneath abdomen.
  2. Rest head on arms, or put a rolled-up towel under forehead. You can also put a rolled towel under each shoulder and under your feet if you like.
  3. Take a deep breath, gently press your pelvis against the pillow, and squeeze your buttocks.
  4. Slowly raise one thigh off the floor, with knee slightly bent. Hold for a count of 2, keeping foot relaxed.
  5. Lower thigh and hip back to ground.
  6. Repeat 10 times, then do 10 with the other leg.

What are the risk factors for osteopenia?

Certain other conditions can also increase your risk of developing osteopenia:

  • anorexia
  • bulimia
  • Cushing’s syndrome
  • hyperparathyroidism
  • hyperthyroidism
  • inflammatory conditions like rheumatoid arthritis, lupus, or Crohn’s

Video related to osteopenia