Osteoporosis vs Osteopenia
Preserving the health and strength of bones as individuals age is an important issue that is not overlooked in the medical community. However, statistics show that osteoporosis and osteopenia are major health problems for over 50 million women and men aged 50 and over in the United States (US). Both conditions are characterized by low bone density, or low bone mass, but osteoporosis occurs due to the progression of osteopenia.
Osteoporosis is defined as the loss of bone mass and the deterioration of bone tissue that leads to increased bone fragility as well as enhanced fracture risk. Approximately half of the women and one-fourth of the men who are diagnosed with osteoporosis suffer from broken bones due to this condition. In addition, osteoporosis is associated with about 19 billion dollars in medical costs annually, and it is estimated that the costs will rise to at least 25 billion annually by 2025.
Osteopenia is a distinct condition that is defined as a decrease in bone mineral density (bone mass) that is lower than normal but not low enough to meet the criteria for an osteoporosis diagnosis. A specialized test called a dual-energy x-ray absorptiometry (DEXA) scan helps determine whether an individual has osteopenia or osteoporosis.
A DEXA scan provides a number called a T-score that represents how much a patient’s bone mass differs from the bone mass of the average healthy adult. A T-score within one standard deviation (SD) reflects normal bone mass. A T-score that is 1 to 2.5 SDs below the average indicates that an individual may have osteopenia — a mild form of osteoporosis. A T-score that is more than 2.5 SDs below the average T-score indicates the potential presence of moderate to severe osteoporosis.
One of the main risk factors for osteopenia and osteoporosis is aging.
Additional factors that increase the risk of developing osteoporosis include:
- A lack of exercise
- Dramatic weight loss
- Tobacco and alcohol abuse
- A family history of fractures
- Gender (higher prevalence in women)
- Eating disorders (anorexia or bulimia )
- Low body weight or a thin and slender build
- Long-term use of certain medications (e.g., corticosteroids, thyroid medication, anticonvulsants)
However, people with osteoporosis or those who are at risk of developing this condition due to osteopenia often benefit from physiotherapy. During the consultation, a physiotherapist will discuss medical history in detail to assess factors that may contribute to the progression of osteopenia or osteoporosis. If osteoporosis is suspected or a patient has an increased risk of bone fracture due to low bone density, which reflects osteopenia, the physiotherapist may also recommend more precise testing.
The main goals of physiotherapy include demonstrating safe ways to move the body, lift items, and maintain proper posture. The therapeutic plan also entails learning exercises that help slow the loss of bone mass. Bone problems may lead to physical inactivity, but this can worsen bone tissue deterioration, accelerate osteopenia or osteoporosis, and increase the risk of falling and fracturing bones. Although both of these conditions are associated with reduced bone mass, diagnosing and treating osteopenia early on is an important factor that can help prevent the occurrence of osteoporosis and future health issues.
References
1. The Bone Health & Osteoporosis Foundation. What is osteoporosis and what causes it? Retrieved June 15, 2023. Available at https://www.nof.org/patients/what-is-osteoporosis/
2. National Osteoporosis Foundation. Osteoporosis fast facts. Retrieved June 16, 2023. Available at https://www.bonehealthandosteoporosis.org/wp-content/uploads/2015/12/Osteoporosis-Fast-Facts.pdf
3. Consensus Development Conference V, 1993. Diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med. 1994;90:646-650.
4. Varacallo MA, Fox EJ. Osteoporosis and its complications. Med Clin North Am. 2014;98(4):817-831.
5. Hartely GW, Roach KE, Nithman RW, et al. Physical therapist management of patients with suspected or confirmed osteoporosis: A clinical practice guideline from the Academy of Geriatric Physical Therapy. J Geriatr Phys Ther. 2022;44(2):E106-E119.