Osteoporosis Symptoms, Causes & Prevention

Osteoporosis is the most common age-related bone disease, affecting millions of adults and quietly raising the risk of fracture long before any symptoms appear. Because it develops without pain or warning signs, understanding your risk factors and taking preventive steps early is one of the most important things you can do for your long-term mobility and independence.

Kathy Weber, MD, MS, of Midwest Orthopaedics at Rush (MOR), breaks down what osteoporosis is, who is most at risk, and the lifestyle habits that can help protect your bones at every age.

What Is Osteoporosis?

Osteoporosis is a chronic skeletal disorder that causes bones to lose density and become weaker, more porous, and more fragile over time. As bone micro-architecture deteriorates, even low-impact events, such as a minor fall, a hard sneeze, or bending to pick something up, can result in a fracture.

Some bone loss is a normal part of aging. Osteoporosis develops when that loss becomes significant enough to compromise a bone's ability to withstand everyday stress.

Osteoporosis is often called a “silent disease” because it typically causes no noticeable symptoms in its early stages. Many people don't realize their bone density has declined until they experience a fracture, most commonly in the wrist, hip, or spine. These fractures can lead to chronic pain, reduced mobility, and a loss of independence, which is why early awareness and screening matter so much.

Is Osteoporosis Preventable?

Osteoporosis is often partly preventable, though not everyone can avoid it entirely. Bone health is shaped by a mix of genetics, aging, hormones, nutrition, physical activity, medications, and underlying medical conditions.

Bone is living tissue that is constantly being broken down and rebuilt. The body typically builds more bone than it loses until the late 20s or early 30s, the point at which most people reach their peak bone mass. After that, bone loss gradually begins to outpace bone formation.

Because both modifiable and non-modifiable factors influence osteoporosis risk, understanding what you can control is one of the most effective ways to protect your bones.

Modifiable Risk Factors You Can Influence

Nutrition: Getting enough calcium, vitamin D, protein, and overall calories supports the mineral structure and collagen framework that keep bones strong and flexible.

Exercise: Weight-bearing activities like walking, hiking, dancing, jogging, and tennis, along with resistance training, help stimulate bone strength and improve balance.

Healthy lifestyle choices: Avoiding smoking and limiting alcohol protects bone formation, since smoking accelerates bone loss and excess alcohol interferes with it.

Fall prevention: Building strength, practicing balance exercises, maintaining good vision, wearing supportive footwear, and creating a safe home environment all reduce fracture risk.

Medical conditions: Eating disorders and conditions that interfere with nutrient absorption, such as celiac disease, can affect the body's ability to maintain strong bones.

How Much of Bone Health Is Genetic?

Genetics plays a major role in bone health. Approximately 50 to 80 percent of peak bone mass is influenced by inherited factors, which is why some people naturally develop denser, stronger bones than others.

Family history matters, too. If a parent, especially a mother, had osteoporosis or a hip fracture, an individual's own risk may be higher. Genetics can influence bone size, peak bone density, and how quickly bone is lost over time.

Is Osteoporosis Inevitable?

Some bone loss is a normal part of aging, but developing osteoporosis is not inevitable. The goal isn't to prevent all bone loss; it's to build as much bone as possible while young, slow bone loss with age, maintain muscle strength and balance, and reduce fracture risk.

Think of bone health like a savings account. Younger years are when you make deposits by building peak bone mass. Later in life, withdrawals naturally increase as bone loss occurs. Starting with a larger “bone bank” and slowing the rate of loss helps reduce the likelihood of reaching dangerously low bone density.

Does Osteoporosis Affect Men and Women Differently?

Yes. Both men and women can develop osteoporosis, but women are affected more frequently and often at an earlier age. Risk in both sexes is shaped by a combination of genetics, hormones, lifestyle, medications, and underlying medical conditions.

Osteoporosis in Women

Women tend to start life with smaller, thinner bones and a lower peak bone mass than men, and they generally live longer, allowing more time for age-related bone loss. Menopause is one of the biggest risk factors for women. Estrogen helps protect bones by slowing bone breakdown, and after menopause, declining estrogen levels can accelerate bone loss, especially during the first five to ten years, raising the risk of osteoporosis and fracture.

Osteoporosis in Men

Osteoporosis is often thought of as a women's condition, but men develop it too. Men typically build a higher peak bone mass and lose bone more gradually, since testosterone declines slowly rather than dropping sharply the way estrogen does at menopause. Still, risk rises with age, particularly with low testosterone, certain medications, chronic illness, smoking, excessive alcohol use, or a family history of osteoporosis. Because it's underrecognized in men, related fractures can carry serious health consequences.

Can Younger Adults Develop Osteoporosis?

Osteoporosis is far less common in younger adults, but it can occur when something interferes with normal bone development or accelerates bone loss. Risk factors in younger individuals may include:

• Long-term use of steroid medications (such as glucocorticoids)
• Hormonal disorders
• Eating disorders or prolonged inadequate nutrition
• Chronic illnesses that affect bone health or nutrient absorption
• Genetic conditions that affect bone strength

Who Else Is at Increased Risk for Osteoporosis?

• Older age
• Family history of osteoporosis or hip fractures
• Low body weight or significant weight loss
• Early menopause or prolonged periods of low estrogen
• Certain medications, especially long-term corticosteroid therapy
• Conditions affecting calcium or vitamin D absorption
• Physical inactivity

Why Is Bone Health So Important?

Your bones do far more than provide structure and support. Healthy bones allow you to walk, climb stairs, lift groceries, exercise, and maintain an active, independent lifestyle as you age.

Bones also serve important biological functions beyond movement. They store essential minerals like calcium and phosphorus, which the body relies on for muscle contraction, nerve signaling, and blood clotting. Bone marrow, found inside bones, produces new blood cells essential for oxygen transport and immune function. Bones also protect vital organs: the skull shields the brain, the rib cage protects the heart and lungs, and the spine safeguards the spinal cord.

Because bone loss increases the risk of fractures, pain, and reduced mobility, investing in bone health through exercise, nutrition, and healthy habits helps preserve strength, function, and quality of life for years to come.

Lifestyle Habits to Help Prevent Osteoporosis

Healthy bones are built and maintained over a lifetime. While factors like age and genetics can't be changed, these evidence-based habits can help build stronger bones, slow bone loss, and reduce fracture risk.

Eat a Bone-Healthy Diet

Bones need a steady supply of nutrients to stay strong. Calcium provides the mineral foundation of bone, while protein supports the collagen framework that gives bone its flexibility and resilience.

• Include calcium-rich foods such as dairy products, calcium-fortified plant milks, calcium-set tofu, leafy greens, and canned salmon or sardines with bones.
• Add a source of protein to each meal, such as lean meats, fish, eggs, beans, lentils, nuts, or dairy.
• Aim to meet calcium needs through food first, when possible.
• If dietary intake falls short, ask your doctor whether a calcium or vitamin D supplement is appropriate. Supplements should fill gaps, not replace a balanced diet.

Build Bone Health Early, and Keep Investing in It

The foundation for strong bones starts long before older adulthood. Childhood, adolescence, and young adulthood are critical periods for building peak bone mass, and most people reach their maximum bone strength by around age 30. Building stronger bones early creates a reserve that helps protect against age-related bone loss later on. It's never too early, or too late, to support your bones: exercise, adequate nutrition, sufficient calcium and vitamin D, and avoiding smoking can help at any age.

Get Screened, Since Osteoporosis Often Has No Warning Signs

Because osteoporosis typically causes no pain or symptoms until a fracture occurs, screening is important for those at increased risk. A bone mineral density (BMD) test, most often a dual-energy X-ray absorptiometry (DXA or DEXA) scan, can identify bone loss before a fracture happens, allowing you and your provider to build a plan that may include lifestyle changes, monitoring, or treatment. Talk with your primary care provider or an orthopedic specialist about your personal risk factors and the right timing for a DXA scan.

Stay Active With Weight-Bearing and Strength-Training Exercise

Bones respond to physical stress by becoming stronger, and strength training builds the muscle that supports bones, improves balance, and helps prevent falls and fractures.

• Weight-bearing activities: walking, hiking, dancing, tennis, jogging, or stair climbing
• Resistance training with weights, bands, machines, or bodyweight exercises at least 2 to 3 times per week
• Balance and flexibility work, such as yoga or tai chi, to improve stability and reduce fall risk

Avoid Smoking and Limit Alcohol Intake

Smoking reduces bone density and raises fracture risk, while excessive alcohol interferes with bone formation, reduces calcium absorption, and increases the likelihood of falls. Avoid tobacco, or seek support to quit, and if you drink, do so in moderation while staying mindful of how alcohol affects balance.

Maintain a Healthy Body Weight and Adequate Nutrition

Being underweight can increase osteoporosis risk due to lower bone mass and fewer bone-protective hormonal signals. Restrictive dieting or inadequate calorie intake can also deprive the body of nutrients needed for bone maintenance. Focus on balanced meals with enough calories, protein, calcium, and vitamin D, and talk with a healthcare provider or registered dietitian if you have concerns about weight loss or nutrition.

Concerned About Your Bone Health? 

Osteoporosis is manageable when it's caught early, and you don't have to wait for a fracture to take your bone health seriously. If you're experiencing bone or joint pain, have risk factors for osteoporosis, or simply want to understand your fracture risk, the orthopedic specialists at Midwest Orthopaedics at Rush are here to help.

Schedule an appointment with MOR today to talk with a bone health specialist about screening, prevention, and treatment options tailored to you.