Osteoporosis Treatment in Duluth, MN

Osteoporosis is a condition in which the bones become weak and brittle — so brittle that a fall, or even mild stresses like bending or coughing, can cause a fracture. Often called a “silent disease,” osteoporosis causes no symptoms until a fracture occurs. Dr. Adam Elisha, DO, is a board-certified rheumatologist in Duluth, MN who specializes in the evaluation, prevention, and treatment of osteoporosis.

What Is Osteoporosis?

Bone is living tissue that is constantly being broken down and replaced. Osteoporosis occurs when the creation of new bone doesn’t keep up with the loss of old bone. As a result, bones become porous and less dense, increasing the risk of fractures — most commonly in the hip, spine, and wrist. Osteoporosis affects approximately 10 million Americans, with women over 50 at highest risk.

Risk Factors for Osteoporosis

Female sex, especially post-menopause
Age over 50
Family history of osteoporosis or fractures
Small, thin body frame
Low calcium and vitamin D intake
Smoking and excessive alcohol use
Physical inactivity or prolonged bed rest
Long-term use of corticosteroids (such as prednisone)
Certain medical conditions including rheumatoid arthritis, celiac disease, and inflammatory bowel disease
Hyperthyroidism, hyperparathyroidism, or chronic kidney disease

Diagnosing Osteoporosis: DEXA Scan

Osteoporosis is diagnosed with a bone mineral density (BMD) test called a DEXA scan (dual-energy X-ray absorptiometry). This quick, painless test measures bone density at the hip and lumbar spine and produces a T-score. A T-score of -2.5 or below indicates osteoporosis; between -1.0 and -2.5 indicates osteopenia (low bone mass that may progress to osteoporosis). The National Osteoporosis Foundation recommends BMD testing for all women age 65 and older, and for younger postmenopausal women with risk factors.

Treatment Options for Osteoporosis

Treatment depends on the degree of bone loss, fracture history, and underlying risk factors. Options include:

Calcium and Vitamin D: The foundation of bone health. Most adults need 1,000–1,200 mg of calcium daily and 800–1,000 IU of vitamin D.
Bisphosphonates (alendronate, risedronate, zoledronic acid): The most commonly prescribed osteoporosis medications, which slow bone breakdown.
Denosumab (Prolia): A biologic injection given twice yearly that reduces bone breakdown.
Teriparatide (Forteo) and abaloparatide (Tymlos): Anabolic agents that actively build new bone — used for high-risk patients with multiple fractures or very low bone density.
Romosozumab (Evenity): A newer agent with a dual mechanism — it builds bone while also reducing bone breakdown.
Exercise: Weight-bearing and resistance exercise stimulates bone formation and improves balance to reduce fall risk.

Osteoporosis and Inflammatory Diseases

Patients with rheumatoid arthritis, lupus, and other inflammatory conditions treated with corticosteroids have significantly elevated fracture risk. Monitoring and treating bone health is an integral part of managing inflammatory disease, and I routinely assess and address osteoporosis risk in all my patients on long-term steroids.

When to See a Specialist About Your Bones

Ask for a bone-health evaluation if you have broken a bone from a minor fall (a fragility fracture), take corticosteroids such as prednisone for more than three months, have a DEXA T-score of -2.5 or lower, live with an inflammatory condition like rheumatoid arthritis or lupus, or have lost height or developed a stooped posture. Early evaluation finds bone loss before the first fracture, when treatment works best and the most options are available.

Frequently Asked Questions About Osteoporosis

At what age should I get a bone density (DEXA) scan?

All women age 65 and older and men age 70 and older should be screened. Younger postmenopausal women and men age 50 to 69 should be tested if they have risk factors such as a prior fracture, long-term steroid use, or a family history of osteoporosis.

Is osteopenia the same as osteoporosis?

No. Osteopenia is milder low bone mass, with a T-score between -1.0 and -2.5, and it can progress to osteoporosis. It is often managed with calcium, vitamin D, exercise, and risk-factor changes, with medication added when fracture risk is high.

Can osteoporosis be reversed?

Osteoporosis cannot be fully reversed, but treatment can meaningfully increase bone density and lower fracture risk. Anabolic medications such as teriparatide and romosozumab actively build new bone in patients at high risk.

Why would I see a rheumatologist for osteoporosis?

Rheumatologists manage bone health closely, especially for patients with inflammatory disease or long-term steroid use. They evaluate secondary causes of bone loss, interpret DEXA results, and select among the full range of osteoporosis medications.

Related Rheumatology Resources

Osteoporosis Care in Duluth, MN

Don’t wait for a fracture to find out your bones are at risk. Dr. Adam Elisha at St. Luke’s Rheumatology Associates in Duluth provides comprehensive osteoporosis evaluation and treatment. Call (218) 249-6960 to schedule your appointment.