Understanding Osteoporosis: Screening, Risk Factors and Prevention

Bone is living tissue that is constantly breaking down and rebuilding throughout life. As people age, this process can become unbalanced, causing bones to lose density and strength. Osteoporosis is a bone disease that occurs when the body loses too much bone, makes too little bone or both.  

Brad Davis, DPT, OCS, MTC, a physical therapist and orthopedic clinical specialist at Covenant Health Claiborne, explains, “Osteoporosis refers to bones that have become weak or brittle. Bones can become so fragile that a fall, bending over or even coughing can result in a fracture.” 

Symptoms of Osteoporosis 

Most people experience no symptoms of osteoporosis until a fracture occurs. As bones weaken, symptoms may include: 

• Back pain caused by a spinal compression fracture 

• Loss of height over time 

• Stooped posture 

• Bones that break more easily than expected 

• Reduced mobility following a fracture 

The Bone Health and Osteoporosis Foundation notes that the first sign of osteoporosis is often a fracture. Common fractures include a broken wrist, hip or vertebra. 

Prevention Strategies 

While osteoporosis cannot always be prevented, healthy lifestyle choices can significantly reduce bone loss and fracture risk. 

“Bone density or bone strength is very important for decreasing the risk of fractures,” Davis says. “Bone breaks can cause serious pain and disability. Therefore, minimizing the risk of bone breaks is very important.” 

You can support lifelong bone health by: 

• Avoiding smoking 

• Limiting alcohol intake 

• Maintaining a healthy body weight 

• Consuming adequate calcium and vitamin D 

• Participating in regular weight-bearing exercise 

• Performing resistance-training activities 

• Improving balance and coordination to reduce falls 

• Discussing medications and risk factors with your healthcare provider 

• Receiving recommended bone-density screenings.  

Who Is At Risk? 

Researchers continue to identify several factors that increase the risk of osteoporosis. Women remain at greater risk than men due to hormonal changes associated with menopause. However, osteoporosis is not exclusively a women’s disease. Millions of men have osteoporosis or low bone mass. 

According to Healthline.com, risk factors include: 

• Age over 50 

• Female sex, especially after menopause 

• Family history of osteoporosis or hip fracture 

• White or Asian ancestry 

• Low body weight or small body frame 

• Smoking 

• Excessive alcohol consumption 

• Physical inactivity 

• Low calcium or vitamin D intake 

• Long-term corticosteroid use 

• Certain endocrine, gastrointestinal, and autoimmune disorders 
• Osteopenia (low bone mass)  

Davis notes that genetics also plays an important role. “Knowing your family history can help you and your healthcare provider better understand your personal risk and determine when screening is appropriate.” 

Screening and Diagnosis 

Since early 2025, one of the most significant updates in osteoporosis care has been the release of updated United States Preventive Services Task Force screening recommendations. USPSTF now recommends: 

• All women age 65 and older should be screened for osteoporosis 

• Dual-energy X-ray absorptiometry (DEXA or DXA) scan testing should be conducted with or without fracture-risk assessment tools 

• Postmenopausal women younger than 65 should be screened if they have risk factors that increase fracture risk 

There is currently insufficient evidence to recommend routine screening for all men. However, organizations such as The Bone Health & Osteoporosis Foundation continue to support screening discussions for men age 70 and older or those with significant risk factors.  

Treatment Options 

Researchers and professional organizations such as those at Longevity Today are also placing greater emphasis on:  

• Individualized treatment plans 

• Fracture-risk assessment tools such as FRAX  

• Therapies that combine bone-building and antiresorptive medications for patients at very high fracture risk 

“Weight-bearing and strengthening exercises help maintain bone density and improve balance, which can reduce the risk of falls and fractures,” Davis says.  

Davis recommends a combination of: 

• Weight-bearing exercises: Any activity where you must hold your body up against gravity such as walking, hiking or stair climbing 

• Resistance training with bands: This type of workout includes moves that use your body weight to strengthen your bones and muscles. Examples include push-ups, squats and lunges 

• Balance exercises: The goal with balance exercises is to help prevent falls and improve how well you move. Examples of balance exercises include yoga, tai chi or simply standing on one foot for 10-30 seconds at a time.  

Osteoporosis vs. Osteopenia 

Osteopenia is the loss of bone density. Your bones lack minerals, and it makes them weak. Osteopenia can eventually become osteoporosis if preventive measures are not taken. According to Web MD, about 40 million people in the United States have osteopenia. 

Covenant Health Bone Density Screening 

Bone density testing can help identify osteoporosis before a fracture occurs, determine fracture risk and monitor treatment progress. Covenant Health offers DEXA bone-density screening services at multiple locations. A physician order is required for screening. Covenant Health Diagnostics locations also offer cash-pay options for eligible patients.  

Call 865-374-4000 for information or view a list of our providers if you need a personal physician to help you achieve your best health.