What is osteopenia and how is it diagnosed?
Osteopenia is a condition in which your bone density is lower than normal for a young, healthy adult, but not as low as it would be with osteoporosis. Osteopenia causes bones to become weakened. If not addressed, it can progress to osteoporosis, which makes the bones more brittle and can lead to bone breaks or fractures in minor falls and accidents. Although anyone can develop osteopenia, certain factors may make you more likely to develop osteopenia, such as being female, post-menopausal, older, or being Caucasian or Asian. You may also be at risk if you have a family history of osteopenia or osteoporosis, certain underlying chronic diseases, or need for medications that have detrimental effects on bone. Factors that you can change include low levels of physical activity, poor nutrition, smoking or excessive alcohol consumption. Osteopenia is diagnosed by a DXA scan, which measures bone density levels. The results from a DXA scan are reported as a T-score.
Osteopenia can also be diagnosed if you have had a fracture of almost any bone in a minor fall or accident. Some fractures, especially those of the spine, can occur even if you have had no trauma at all. Spine fractures from osteopenia or osteoporosis may cause substantial pain, but sometimes there is no pain. In those cases, there may be some loss of height or change in posture or body shape that is a clue that you have had a spine fracture. It’s important to discuss your fracture history with your doctor because having already had a fracture increases your risk of having another one.
Since many fractures occur in falls, it is also important to discuss a history of falls with your doctor or any noticeable balance issues that might increase your risk of falls.
Now what? Use this checklist as a guide for what you should do after being diagnosed with osteopenia.
Your Osteopenia Checklist
1. Understand your T-Score.
Your T-score will determine how advanced your bone loss is. A T-score of 0 is equal to the average bone density of a young, healthy adult. A T-score of -1 to -2.5 is considered low bone mineral density or osteopenia. It could progress to osteoporosis if your T-score drops to -2.5 or lower. Bone density is measured in both the lower spine and the hip. You can be diagnosed with osteopenia if either of the measurements falls in the range of -1 to -2.5.
In order to prevent your condition from progressing, you might need to make some lifestyle adjustments, such as taking supplements, changing or adding in an exercise routine or changing your diet.
2. Ask questions.
If you’ve been diagnosed with osteopenia, you probably have a lot of questions. Keep a list of questions to ask your doctor and make sure you learn more about osteopenia and how it affects you, specifically. There is a lot of great information on the internet, but it can be overwhelming. Your doctor knows you, your history, and your current condition best, so they can make suggestions that are most appropriate for you.
3. Make a plan with your doctor.
What should you do now? Do you need to take medications for osteopenia or supplements, or can you simply make lifestyle adjustments to treat your osteopenia? What is the prognosis? When will your next DXA scan be? Make a plan with tangible next steps so you aren’t in the dark trying to manage this new diagnosis. Also, make sure the plan is one with which you are comfortable.
4. Balance assessment.
Falls can much more easily lead to fractures in someone with osteopenia, and can be catastrophic for people with osteoporosis since bones fracture easily. Have a professional such as a physical therapist (PT) assess your strength, balance and general mobility to get a sense of whether or not you are at risk for falls. Knowing where you stand in terms of balance will help you and your doctor or PT formulate the appropriate plan to ensure that you decrease your risk of falls.
5. Adjust your diet.
In general, eating foods rich in calcium and vitamin D can help boost or maintain bone density. When you provide your body with the right vitamins and minerals, it gives your body the resources it needs to build new bone more easily. There are also a handful of foods to avoid eating after being diagnosed with osteopenia to ensure that you aren’t doing further damage to your bones.
6. Lifestyle changes.
How you treat your body in your day-to-day routine can really impact your bone health. Eating habits, stress, alcohol intake, smoking, and physical activity play a large role. Even knowing if you should be careful how you move is important. Meeting with a physical therapist, a doctor, a nutritionist or a social worker can help put together a plan to make sure you have the resources you need to live a lifestyle that allows for healthier and stronger bones.
7. Exercise plan.
Do you have an exercise plan in place? Maybe it needs some adjusting for extra bone benefits. We've tried to make things easy for you. By joining Wellen, you'll have access to expert-curated, safe, bone-building exercises designed specifically for you. It’s also worth reading more about the best exercises for osteoporosis. The Bone Health & Osteoporosis Foundation recommends performing weight-bearing exercise (30 minutes a day on most days of the week), muscle-strengthening exercises (2-3 days per week), and balance exercises (every day). Walking, stretching, and resistance training are great ways to maintain bone health. There are also certain exercises that should be avoided in order to preserve bone integrity.
8. Set goals.
What are your goals? Maybe you've never exercised before and you are aiming to walk 5 days a week. Maybe your goal is to give up smoking. Maybe you want to be strong enough to lift your grandchild without having to worry about getting hurt. Whatever your goal may be, write it down, ask professionals how you can go about achieving it, and get started!
9. Choose a team to manage your care.
There isn’t just one provider who can help. Since so many factors can impact bone health, there are various professionals who can help you in different ways.
- A physical therapist can help assess your functional mobility, balance and pain.
- A doctor can order a DXA scan, interpret the results and set a plan moving forward. They can also give recommendations on supplements and prescribe appropriate medications.
- A nutritionist can set forth a healthier eating plan and help you find various and creative ways to incorporate foods rich in vitamin D and calcium into your diet.
- A trainer can guide you in a safe exercise program.
- Finding a fitness community, especially with people also with osteoporosis, can be motivating and emotionally supportive.
- A social worker can provide stress management techniques and aid with any psychological barriers that might prevent you from achieving your goals.
10. Find support.
As mentioned above, there are several providers who can provide support and resources to help improve your bone health. Communicating your goals with your friends and family can also make lifestyle changes more seamless. However, sometimes having a community of peers experiencing the same diagnosis can be both uplifting and motivating. Unfortunately, osteopenia and osteoporosis are not uncommon. According to the Bone Health and Osteoporosis Foundation, 1 in 2 women will break a bone due to osteoporosis. The good news is that there are plenty of other people out there who are going through this too. By taking charge of your bone health now, you may be able to prevent it from becoming osteoporosis.