Prevention · · 7 min read

Osteoporosis: symptoms, risks and bone protection

Osteoporosis makes bones weaker and more likely to break, and it usually causes no symptoms until a bone does break. A bone density scan can find it earlier, and exercise, enough calcium and vitamin D, not smoking and fewer falls all lower the chance of a fracture. A broken bone from a minor fall is a reason to ask your primary care provider about bone health, not just bad luck.

Illustration of a white bone with small pores and a dumbbell on a pale blue circle

In short

  • Osteoporosis is a silent disease. There are usually no symptoms until a bone breaks, most often the hip, spine or wrist.
  • Bones affected by osteoporosis can break from minor falls or everyday strains such as bending, lifting or coughing.
  • Strength training and balance work protect bones and lower fall risk. Quitting smoking and drinking alcohol only in moderation also help.
  • Calcium and vitamin D come best from food first. Ask your provider before starting supplements.
  • A bone density scan (DXA) is the standard test. Medicines that slow bone loss or build bone are available for people at high risk.

What happens to the bone

Osteoporosis is a bone disease in which bone mass and mineral density decrease or the bone structure changes, so bones become weaker and more likely to fracture. Some bone loss is a normal part of aging, but some people lose it much faster.

Fractures most often affect the hip, spine and wrist. Broken bones in the spine are a common cause of long-term pain, and they can cause height loss or a stooped, forward-bent posture. Sometimes the first sign is a rib or vertebra that gives way after a cough or a sneeze.

Who is at higher risk

  • Older age, and being female, especially after menopause, early menopause or removal of the ovaries.
  • A family history of osteoporosis, particularly a parent's hip fracture.
  • A small body frame, low body weight or a past or current eating disorder.
  • Long-term use of steroid tablets, and some other long-term medicines. Never stop a prescribed medicine on your own; ask your provider.
  • Conditions such as rheumatoid arthritis, hormone-related disorders and diseases that interfere with absorbing nutrients.
  • Low calcium or vitamin D intake, smoking, heavy alcohol use and not exercising.

How it is diagnosed

A DXA scan of the hip and spine is generally considered the most reliable way to diagnose osteoporosis and predict fracture risk. It is quick and painless. The U.S. Preventive Services Task Force recommends screening women over 65, and younger women with factors that raise their risk. There is no screening recommendation for men because the evidence is lacking, so men with risk factors should discuss it with their provider.

Providers may also use an online tool such as FRAX to estimate your chance of a fracture in the future, which combines age, sex and other risk factors with scan results. Your provider explains what your own results mean.

Exercise that protects bones

  1. Strength or resistance trainingAmong the best activities for bone health. It also builds muscle and strength.
  2. Weight-bearing activityWalking is one example of exercise that keeps bones strong. Swimming and cycling are good for the heart but load bones less.
  3. Balance and coordinationTai chi is one example. Better balance lowers the chance of falling.
  4. Ask for a safe programIf you already have osteoporosis, a physical therapist can tailor a program. Avoid high-impact exercise unless a professional agrees.

Preventing falls

A fracture usually needs two ingredients, a fragile bone and a fall. You can work on both.

  • Remove things you could trip over, including loose cords and clutter.
  • Add grab bars in the shower and by the toilet, railings on both sides of stairs, and brighter lighting.
  • Wear supportive shoes with thin nonslip soles and use nonslip mats.
  • Have your eyes examined at least once a year and keep your glasses up to date.
  • Ask your provider or pharmacist whether any medicine could make you dizzy or sleepy.
  • Keep your phone with you so you can call for help.

Calcium and vitamin D

Calcium and vitamin D are part of a bone-friendly diet. Good sources of calcium include dairy foods, dark leafy greens, canned fish eaten with the soft bones and fortified foods. Vitamin D comes from fatty fish, egg yolks, fortified foods and sunlight on the skin.

Whether you need a supplement, and how much, depends on your diet and your health. Your provider may check your vitamin D blood level. Taking more than you need does not strengthen bone further. For more on food sources, see our calcium guide.

Treatment in general terms

Treatment aims to prevent fractures. Whether you need it depends on your fracture risk, which takes into account age, sex and scan results. Several classes of medicine exist. Some slow bone loss, such as bisphosphonates, and others help build new bone and are used for people at high risk.

Prescribed medicines can prevent fractures in people who already have osteoporosis, so take them as prescribed by a doctor and do not stop on your own.

Red flags and when to see a provider

Red flags: call 911 or go to an emergency department after a fall if you cannot put weight on your leg or you have severe pain in the hip or groin, even if the leg looks normal. Seek care urgently for sudden severe back pain, especially with weakness or numbness in the legs.

Book an appointment soon if you notice that you are getting shorter, your back is becoming more rounded, or you have broken a bone from a minor fall. Questions to ask: Do I need a bone density scan? What is my fracture risk? Do I need supplements? Which exercises are safe for me?

Questions and answers

Does osteoporosis hurt?

Not until a bone breaks. The pain people notice usually comes from a fracture, most often in the spine, wrist or hip.

Is calcium alone enough to protect my bones?

No. Food sources of calcium and vitamin D are one part of the picture, alongside exercise, not smoking, moderate alcohol and avoiding falls.

Which exercise is best for bones?

Strength training is among the best, and walking is a weight-bearing option. Swimming and cycling are good for general health but put little load on bones.

Is the scan safe?

A DXA scan is short and painless, and it is the test most often used to diagnose osteoporosis and estimate fracture risk.

Why am I getting shorter?

Fractures of spinal bones can cause height loss and a stooped posture. It is worth mentioning to your provider so they can decide whether a scan is needed.

Sources

  1. NIAMS — Osteoporosis
  2. NIAMS — Osteoporosis: diagnosis, treatment and steps to take
  3. NHS — Osteoporosis
  4. CDC — Fall prevention for older adults
  5. MedlinePlus — Calcium in diet

Sources checked on 29 October 2026.

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