Bone health is as crucial for life as your body’s health. Generally, you bother about your other health issues but do not pay attention to your bone’s health and strength. As a result, bones become much weaker over time that may cause osteopenia and osteoporosis.
Both are bone-related diseases in which bone mass and mineral density reduce significantly as compared to a normal healthy individual. This condition eventually leads to a fracture.
In this article, we have discussed the symptomatic differences, causes, and treatment options of osteopenia and osteoporosis.
How Can You Define Osteopenia and Osteoporosis
“A bone disorder in which patient suffers from lower bone mass, strength and mineral density as compared to bones of a healthy individual is called osteopenia”.
Osteopenia is less severe than osteoporosis and it’s actually progression towards Osteoporosis.
“Severe bone disorder in which bones become more brittle and hollow due to lesser density of bone tissues as compared to osteopenia is called osteoporosis”.
Osteopenia Vs Osteoporosis: How to Diagnose?
Osteopenia develop usually with no distinct symptoms in the starting until it progresses towards osteoporosis. Your doctor recommends certain bone density tests for evaluating the level of bone vigor.
A Dual-energy X-ray absorptiometry scan of the lower spine and hip area is performed to evaluate bone health and mineral density (BMD). To get a clear idea about bone health, Fracture Risk Assessment Tool (FRAX) score is analyzed.
Interpretation of BMD Score
Both the above-mentioned bone diseases differ mainly on the severity of bone damage. T Score in BMD Testing indicates best the value and severity of both.
Osteopenia patients show the value of BMD score ranging from -1 to -2.5 and osteoporosis patients as less than -2.5. T-score test result even lower than -1 SD (standard deviation of a young healthy person bone score and patient score) is still considered as healthy.
| Bone Density | T-Score |
| Normal Individual | +1 to -1 |
| Osteopenia | -1 to -2.5 |
| At-Risk of Osteoporosis | -2.5 or lower |
Osteopenia Vs Osteoporosis: Symptomatic Differences
These can be differentiated on the basis of the severity of the disease and available treatment options. Osteopenia is the initiation or progression towards osteoporosis. It usually relates to losing height at the aging phase due to loss in bone mineral density.
Osteopenia is not usually as complicated as osteoporosis so its progression can be minimized by following some appropriate preventive measures. The most important initial symptoms of osteopenia are:
- Bones become hollow and weak
- Severe joints & back pain
- Frequent muscle contractions
- Loss of height due to change in posture
Osteoporosis (porous bones) causes the bones to become more brittle and fragile with each passing day. Thus, severe bone fracture and injury may occur due to more porous and weak bones. The most important symptoms of osteoporosis in addition to above mentioned are:
- Swelling of bones and joints
- Twisting and bending of bones and spine
- Spine or vertebral compression fracture
Osteopenia Vs Osteoporosis: Causes
Multiple factors may affect the development of the bone disease and its severity. These factors mainly include environment, genetics, hormones, age, gender, and nutrition. Some major causes for developing osteopenia and its progression towards osteoporosis are listed below:
1- Regular use of alcohol and soft drinks
Alcoholic beverages and soft drinks contain a much higher concentration of phosphorus that disturbs the calcium/phosphorus ratio in the body. The more phosphate level obstructs the absorption of calcium in bones. Consequently, bones become more brittle, porous, and weak resulting in osteopenia or osteoporosis.
2- Lack of physical activity and regular exercise
A sedentary lifestyle is a major contributing factor in developing bone disease. Bone strength and muscle mass are interrelated and dependent on each other. No physical activity causes the bones and muscles to become stiffer so, enhances the possibility and rate of fractures.
3- Calcium & Vitamin-D Deficiency
Calcium and vitamin D are crucial to maintaining a good body skeleton. A lower level of vitamin D causes impaired mineralization of bones and hence acts as a contributing factor in the weakening of bones. Without a proper concentration of vitamin D, the bones do not absorb calcium properly resulting in hollow and porous bones.
4- Lesser concentration of estrogen level in the body
A well-maintained estrogen level is a key component to maintaining good skeletal growth. Women reaching menopause suffer from less production of estrogen levels. This less production of estrogen reduces bone mineral mass. Studies show that about 20% of bone mass is lost in women after five to seven years of menopause stage.
At this point, doctors may recommend estrogen therapy alone or combined with progesterone hormone depending upon the condition of the patient. These therapies prevent menopausal symptoms as well as bone loss.
However, in some cases, doctors do not recommend these therapies due to possible health threats of breast cancer, heart attack, strokes, or even cognitive decline.
5- Not Attaining Maximum Bone Mass
Your bones constantly go through the process of renewal. This process slows down in the early 20s, after that they attain their maximum mass at about 30 years of your age.
According to recent research published in 2021, one of the most significant causes of developing osteopenia is not attaining the maximum bone mass or losing it after reaching its peak. Genetics and certain diseases are the most important contributing factors for this situation.
Who Is At More Risk For Osteopenia and Osteoporosis?
Everyone doesn’t suffer from osteopenia or osteoporosis. Certain factors determine the chances of developing these issues as well as the severity level. Some of these risk factors are described below:
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Gender
Most women are at more risk of developing these issues due to multiple reasons.
“National Osteoporosis Foundation states that almost 80% of the Americans with osteoporosis are women. About 50% women of more than 50 years suffer from bone breakage due to osteoporosis”.
There are some key factors and reasons for more bone breakage issues in females than males. These include:
- Women have less bone mass as compared to men.
- More Calcium and Vitamin D deficiency in pregnancy.
- A lower estrogen level in women near to menopause stage predominantly decreases the bone density and hence the chances of osteoporosis increase.
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Age for Osteopenia and Osteoporosis
Crossing the age of 50 is riskier for developing these bone problems. But you can decrease this risk by adopting healthy aging tips and tricks like exercise, yoga, proper diet, or mental health.
According to Bone Health and Osteoporosis Foundation, 1 in every 2 women and 1 in every 4 men above age 50 suffer from bone breakage due to osteoporosis.
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Family History
People with a family history of bones related problems are 50-80% more at risk of developing osteoporosis. Genetic factors control about 80% of chances to attain and retain bone mineralization levels.
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Lifestyle
Unhealthy lifestyles, malnutrition, improper food choices as junk food, alcoholic beverages, and lack of physical activity are the most important lifestyle choices that increase the risk of osteopenia and osteoporosis. Keeping a habit of regular exercise, yoga, or meditation is an insightful approach for cardiovascular fitness and healthy life.
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Other Medical Reasons
The most common medical issues that enhance the chances of osteopenia and osteoporosis are hyperthyroidism, chemotherapy for cancer treatment, autoimmune disorders, HIV, Chronic Kidney Disease, liver diseases, diabetes, organ transplants, celiac disease, and spinal cord injuries.
Osteopenia and Osteoporosis: Treatment/Management
Slowing down or hindering loss of bone mineral density is a major treatment plan for patients suffering from osteoporosis. It is possible to minimize the loss of bones strength and density by following some key points given below:
Lifestyle Modifications
Reducing alcoholic and soft drinks consumption, leaving a sedentary lifestyle, focusing on a morning walk and regular exercise are the key points to reduce the chances of developing bone-related issues.
A famous saying about lifestyle modifications for better health is
Early to Bed and Early to Rise Makes a Man Healthy, Wealthy and Wise
Modern science confirms the positive health consequences of this practice. The late-night study, use of social media, electronic gadgets, watching movies prove to be detrimental to eyes, brain, posture, and overall health.
Similarly, yoga and tai chi can simultaneously reduce stress and improve the balance and vigor of bones.
Nutritional Balance in Diet
Diet plays a crucial role in bone and muscles strength. It starts to influence overall health especially bones in very early childhood stages or even in offspring during pregnancy.
Adding plenty of proteins, fresh fruits, vegetables, calcium, vitamins to your diet have a positive influence on bones strength and vigor.
Recent studies suggest that vitamin C and K might also have a strong positive impact on bones health.
Ensure to take enough calcium, vitamin C, D, and K to prevent bone decay and fracture.
According to The National Osteoporosis Foundation report, adults above age 50 should take 1200-1500mg Calcium and 800-1000 IUs of Vitamin D per day.
Research work published in NCBI suggests that you should take protein between 0.8 to 2g per Kg body weight. A protein diet less than this suggested value may result in muscles weakness, bones and joint pain as well as bone or hip fracture.
Proper Exercise for Osteopenia and Osteoporosis
Physical activity and exercise cause the development of more bone density and strength so you can regain your normal bone vigor.
The best exercises for osteopenia and osteoporosis are listed below:
- Weight-bearing aerobic exercises
- Posture improving exercises
- Stretching exercises
- Resistant training exercises
Resistance & Stretching Exercises
Doing resistance and stretching exercises mean doing a workout against the weight or direction of an object. These exercises increase bones strength and density and reduce the risk of fractures.
Different types of resistance and stretching exercises include:
- Swimming
- Weight-bearing exercises
- Stretching with resistance tubing of different strengths
Yoga
It is a useful treatment option for people suffering from osteoporosis. It relieves your symptoms, improves bone and muscle health, and reduces complications. Gentle yoga poses definitely improve the flexibility and agility of the body.
“According to The National Institute of Health, yoga has a prominent effect to improve BMD in postmenopausal women with osteoporosis.
They report that doing 12 minutes of yoga daily may help to regain the lost mineral density.”
Vitamin D for Osteopenia & Osteoporosis
Vitamin D prevents the bones from thinning due to arthritis, or osteoporosis. It has anti-inflammatory effects so helps to reduce the symptoms of bone-related issues. If the body contains a too low level of vitamin D, it results in osteomalacia and rickets.
Sun exposure is a great source of vitamin D for the body. When you expose to the sun, your skin starts to synthesize vitamin D from the cholesterol in skin cells. It depends on region to region to get a good time to sit under sunlight.
However, the best time to be considered is from 7 am to 9 am after that it may be harmful to the body to sit in the sun.
Milk, yogurt, dairy products, and green leafy vegetables are good sources of getting calcium and vitamin D through diet. Patients with osteoporosis or osteopenia are mostly advised to take supplements containing calcium and vitamin D to meet the demands of bones and the body.
Concluding Remarks
Osteopenia and osteoporosis are serious disorders of the bones with distinctions based on the severity and treatment options. A sedentary lifestyle matters a lot in losing bone mineral density and muscle tissues. Early diagnosis and adopting healthy lifestyle choices like exercise, proper nutrition and supplements slow down or stop the progression of the disease.
