10 Myths About Osteoporosis


Robert H. Shmerling, M.D.

Content provided by the Faculty of Harvard Medical School

Chances are you've heard a lot about osteoporosis. This remarkably common condition affects 8 million women in the United States. And recent advances in its diagnosis and treatment make it a condition that's often in the news.

Why should we care about osteoporosis? Just having the disease is not the problem. The problem is the broken bones (fractures) that can occur in people with osteoporosis. They cause enormous suffering, often require surgery, and may lead to loss of independence or even death. Current estimates suggest that half of all women over age 50 will suffer a fracture related to osteoporosis.

Unfortunately, there's a lot about osteoporosis that is misunderstood. So, let's talk about a few of the myths and set the record straight.

What's in a Name?

"Osteo" means bone and "-porosis" refers to the porous quality of the bone. Porous bones have fewer connections within the bones than needed for optimal bone strength. Just as a bridge with too few supportive struts may be prone to collapse, people with osteoporosis are prone to bone fracture, especially of the hip, pelvis, spine and wrist.

Myths and Truths

Myth #1: Osteoporosis is painful.

This is probably the most common myth. In fact, osteoporosis causes no symptoms unless a bone breaks. In fact, most people with osteoporosis don't know they have it unless they break a bone or learn of the diagnosis from a bone mineral density test.

Myth #2: You have to fall to break a bone due to osteoporosis.

Actually, certain fractures, especially those of the spine (called compression fractures) may happen without a fall or any recognized injury.

Myth #3: All osteoporotic fractures are painful.

It's generally true that when you break a bone, it hurts. And hip, pelvis or wrist fractures due to osteoporosis are almost always painful. But, compression fractures, as mentioned above, may develop gradually and painlessly, making the normally rectangular spine bone crunched into more of a triangle. It's one of the reasons people with osteoporosis often lose height and can develop a hunched-over posture.

Myth #4: Osteoporosis is unlikely if your posture is normal.

The other part of this myth is that a bent-over posture is a cause of osteoporosis. While compression fractures can cause the spine to bend forward (a condition called kyphosis), plenty of people with osteoporosis have perfectly normal posture. "Poor posture" (however that's defined!) does not cause osteoporosis and does not make existing osteoporosis worse. The opposite is also untrue: Good posture does not prevent osteoporosis.

Myth #5: Only postmenopausal women get osteoporosis.

While osteoporosis is 4 to 5 times more common among women than men (and it affects mostly postmenopausal women), an estimated 25% of men will break a bone due to osteoporosis at some point in their lives. In younger people, there is often at least one risk factor for the disease, especially family history or use of medicines called corticosteroids. Among men, advanced age and low testosterone are important risk factors.

Myth #6: Calcium and vitamin D are adequate treatments for most cases of osteoporosis.

While these nutrients are necessary to build back lost bone mass, they are rarely enough on their own to reverse osteoporosis. To build bone, doctors prescribe medicines called bisphosphonates, such as alendronate (Fosamax) or risedronate (Actonel).

Myth #7: Aggressive treatment of osteopenia (sometimes called "pre-osteoporosis") is always necessary.

The term "osteopenia" means "too little bone." It is not a disease. It refers to low bone mass that is not severe enough to indicate osteoporosis. Osteopenia only slightly increases fracture risk. That's why calcium, vitamin D and exercise (the standard recommendations for postmenopausal women even with normal bone mass) may be all that's necessary to maintain bone health. If you have osteopenia, talk to your doctor about whether you need to do anything other than the routine measures for bone health.

Last Review Date: Dec 8, 2010

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