The Disease That Doesn’t Hurt Until It Breaks: What Maryland Adults Should Know About Osteoporosis

You step off a curb funny and feel a twinge in your wrist. A week later you lean on the counter and something in your back catches. Nothing dramatic. Nothing you’d call a fall. But your body keeps sending small bills for motions that never used to cost anything.

Most people find out they have osteoporosis only after a bone has already broken. That’s what makes it the “silent disease.” May is National Osteoporosis Awareness and Prevention Month, a good reason to take a closer look at the most common metabolic bone disease in the U.S.. At The Centers for Advanced Orthopaedics Orthopaedic Associates of Central Maryland Division (OACM), we see the effects of bone loss every week, usually only after the first fracture has happened. The goal of this article is to move that conversation earlier.

What osteoporosis actually is

Bone is living tissue. Your body constantly breaks down old bone and builds new bone. Osteoporosis happens when that balance tips: you break down bone faster than you rebuild it, and the bones become porous and more fragile. Fragile bones fracture more easily, sometimes from something as small as a bump against a door frame or a minor fall.

There’s an in-between stage, too, called osteopenia. Bone density is lower than normal but not low enough to count as osteoporosis. Osteopenia matters because it’s often the first warning, and the stage where lifestyle and, sometimes, medication can slow things down.

Who’s at risk, beyond the stereotypes

Osteoporosis has a reputation as a “tiny, older woman” disease. It’s a lot broader than that. Known risk factors include:

• Age: risk climbs for everyone after 50
• Sex: women lose bone faster after menopause; BHOF reports that about one in two women and up to one in four men over age 50 will break a bone due to osteoporosis in their lifetime
• Family history: a parent with a hip fracture roughly doubles your risk of a future hip fracture, which is why FRAX-based risk calculators ask about it
• Smaller frame, low body weight
• Certain medications: long-term steroids, some cancer treatments, some reflux medications
• Medical conditions: thyroid disorders, rheumatoid arthritis, celiac disease, chronic kidney or liver disease
• Lifestyle: smoking, heavy alcohol use, low-calcium / low-vitamin-D diet, and very low physical activity

You can’t change your family history or your age. You can often change your activity, your diet, and whether you smoke, and those changes matter.

Warning signs that often get missed

Because osteoporosis itself doesn’t usually hurt, it’s often the fractures, or near-misses, that tell the story. Consider asking your primary care provider or an OACM orthopedic provider about a bone health evaluation if:

• You’ve broken a bone from a minor fall or bump after age 50
• You’ve lost more than 1.5 inches of height from your peak adult height
• Your posture has changed, with a new forward curve in your upper back
• You have sudden, unexplained back pain, especially after lifting
• You have a parent who broke a hip
• You’ve been on long-term oral steroids

How it’s diagnosed

The standard test is a DXA scan (dual-energy X-ray absorptiometry), a short, low-dose X-ray that measures bone density, usually at the hip and spine. Most patients describe it as comfortable and say it takes less time than a dental X-ray. Your provider may also use a risk-calculator tool called FRAX, which estimates your 10-year chance of a major fracture based on your bone density and other factors.

The U.S. Preventive Services Task Force recommends DXA screening for women 65 and older, and for younger post-menopausal women at increased risk. Guidelines for men vary; many clinicians follow the Bone Health & Osteoporosis Foundation Clinician’s Guide and the American College of Radiology recommendation to start screening men at age 70, or earlier with risk factors.

What treatment and prevention look like

Nutrition. Adequate calcium and vitamin D are the foundation. Your primary care provider can check your vitamin D level and recommend dietary or supplement targets.

Weight-bearing and resistance exercise. Walking, hiking, dancing, stair climbing, and light resistance training ask your bones to work against gravity, which supports bone maintenance. Our OACM physical therapy team offers bone-health–friendly programs at eight Central Maryland locations.

Fall prevention. The fracture usually comes from a fall, not the disease itself. Reducing falls matters: good lighting, removed throw rugs, grab bars where needed, balance work, and keeping vision and footwear up to date.

Medication, when appropriate. For patients at higher risk, several medication classes may help. Bisphosphonates are often a first-line choice, and newer bone-building agents (sometimes called anabolic therapies) can actively rebuild bone in selected patients. Medication choice is personalized.

Coordinated care. Bone health sits between orthopedics, primary care, and sometimes endocrinology. At OACM we can help you handle that coordination, and, when a fragility fracture has already happened, we focus on reducing the chance of another one.

Featured provider

Sam V. Sydney, M.D.

Schedule an evaluation

If you’ve broken a bone from a minor fall, lost height, or have a family history of osteoporosis, an evaluation can help you understand your risk and your options. Schedule with an OACM orthopedic provider at our Eldersburg, Fulton, Columbia, or Catonsville clinic. Call (410) 644-1880, dial toll-free (855) 4MD-BONE, or book online.

Frequently asked questions

Disclaimer

The information in this article is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always speak with a qualified orthopedic provider about your specific symptoms and medical history. To schedule an appointment with Orthopaedic Associates of Central Maryland, call (410) 644-1880 or visit mdbonedocs.com.