Osteoporosis is a chronic metabolic bone disorder characterized by reduced bone mass and deterioration of bone microarchitecture, resulting in increased bone fragility and a higher risk of fractures. It is often referred to as a “silent disease” because bone loss occurs gradually and without symptoms until a fracture happens. Osteoporosis commonly affects the spine, hip, and wrist and is a major cause of disability and reduced quality of life, particularly in older adults.

Bone is a dynamic tissue that undergoes continuous remodeling through the balanced actions of bone formation and bone resorption. Osteoporosis develops when bone resorption exceeds bone formation, leading to progressive loss of bone density. Aging is a primary risk factor, but hormonal changes, especially reduced estrogen levels after menopause, significantly accelerate bone loss in women. Men are also affected, particularly with advancing age or underlying hormonal deficiencies.

Additional risk factors include low calcium and vitamin D intake, sedentary lifestyle, smoking, excessive alcohol consumption, long-term use of corticosteroids, certain endocrine disorders, and family history of osteoporosis. In the Middle East, vitamin D deficiency and limited weight-bearing physical activity further contribute to bone health deterioration.

Osteoporosis is typically diagnosed through bone mineral density testing using dual-energy X-ray absorptiometry (DEXA). Results are expressed as T-scores, which compare an individual’s bone density to that of a healthy young adult. Fracture risk assessment tools are often used alongside bone density results to guide treatment decisions.

Clinical consequences of osteoporosis are primarily related to fractures. Vertebral fractures may cause chronic back pain, height loss, and spinal deformity, while hip fractures are associated with significant morbidity, loss of independence, and increased mortality. Early identification and prevention are therefore critical.

Management of osteoporosis focuses on fracture prevention through a combination of lifestyle modification and medical therapy. Adequate intake of calcium and vitamin D is essential to support bone metabolism. Weight-bearing and resistance exercises improve bone strength, balance, and muscle mass, reducing fall risk. Fall-prevention strategies are particularly important in older adults.

Pharmacological treatment is recommended for individuals at high fracture risk. These therapies work by reducing bone resorption or stimulating bone formation, thereby improving bone density and reducing fracture incidence. Treatment choice is individualized based on age, fracture history, bone density, and comorbid conditions.

Long-term follow-up includes monitoring bone density, treatment adherence, and fracture risk. With early diagnosis, appropriate therapy, and sustained preventive measures, osteoporosis-related fractures can be significantly reduced, preserving mobility, independence, and quality of life.