Osteopenia: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Osteopenia?
A primary care doctor, such as a family doctor or an internist (an adult medicine doctor), often finds and follows low bone mass. An endocrinologist (a hormone doctor) or a rheumatologist (a doctor for bone, joint, and muscle diseases) may help in harder cases. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is osteopenia?
Osteopenia means you have low bone mass that is not low enough to be called osteoporosis. People with osteoporosis are more likely to break bones than people without it. Osteopenia is now called low bone mass. Your risk of a broken bone is higher than normal, but not as high as with osteoporosis.
Some people think of it as being like pre-diabetes. If you take steps to protect your bones, osteopenia may not turn into osteoporosis. Low bone mass is common. More than half of U.S. adults aged 50 and older either have osteoporosis or are at higher risk of getting it.
Symptoms
Osteoporosis does not hurt, so people often do not know they have it until they break a bone. The first sign that low bone mass has become osteoporosis can be a broken bone from a minor injury that would probably not have broken a healthy bone.
Bone loss tends to happen most in the spine, the lower forearm above the wrist, and the upper thigh bone, where hip fractures occur. Because there are usually no warning signs, doctors look for low bone mass with a test before a bone breaks.
Causes and who gets it
Low bone mass comes from low peak bone mass, which is how dense your bones were when growth ended, and from bone loss after age 30. With aging, bone formation does not keep up with bone removal, especially in women who are near or past menopause.
Other things can add to the risk of bone loss:
- A family history of osteoporosis.
- Long-term use of some medicines, such as corticosteroids like prednisone or anti-seizure drugs.
How doctors diagnose it
The main test is a bone density scan called DXA. It uses x-rays to measure how much calcium and other minerals are in your bones. The test is safe, accurate, and painless, and it uses less radiation than a regular chest x-ray. Screening is advised for women age 65 and older, and for some younger women who have a higher risk of osteoporosis.
The scan gives a T-score, which compares your bone density with that of a healthy 30-year-old. A T-score of -1.0 or above is normal. A score from -1.1 to -2.4 means you may have bone loss, or osteopenia. A score of -2.5 or below means you likely have osteoporosis.
Your doctor may also check your total fracture risk with the Fracture Risk Assessment Tool, called FRAX. Blood or urine tests may look for treatable causes of bone loss.
Treatment
Your doctor will make a plan from your test results and medical history to protect your bones and prevent falls. The plan often includes some of these steps:
- Eat enough protein, calcium, and vitamin D.
- Take calcium and vitamin D supplements if you cannot get enough from food.
- Exercise, especially weight-bearing and resistance training, which means moving against gravity or against resistance.
- Quit smoking if you smoke and limit alcohol.
- Prevent falls, for example by fixing fall risks at home and doing balance exercises.
Whether you need a medicine depends on your total fracture risk. Some medicines lower the risk of broken bones by increasing bone density, preventing bone loss, or building new bone. Medicines can cause side effects, so ask your doctor or pharmacist if you have questions.
When to see a doctor
Younger women and men of any age may need a bone density test if they have risk factors for osteoporosis. A broken wrist or hip from a minor fall, such as tripping over a rug, is most likely due to underlying bone weakness. If you have a fracture after age 40, tell your family doctor so you can be checked for future fracture risk. Call 911 after a fall or other injury if you may have a broken bone, such as a hip, or have sudden, severe pain or a head or spine injury.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can review your risk factors and medicines, arrange a bone density test, and follow your results over time.
Common questions
Is osteopenia the same as osteoporosis?
No. Osteopenia is low bone mass that is not low enough to be called osteoporosis. Your risk of a fracture is higher than normal, but not as high as with osteoporosis.
Does osteopenia always turn into osteoporosis?
No. If you take steps to protect your bones, osteopenia may not progress to osteoporosis. Your doctor will usually repeat DXA scans every 2 or 3 years to recheck your bones.
Can diet and exercise help with osteopenia?
Yes, they are part of the plan to protect your bones. Doctors may advise enough protein, calcium, and vitamin D, plus weight-bearing and resistance exercise. Ask your doctor what is safe and right for you.
Do I need medicine for osteopenia?
It depends. Treatment recommendations depend on your total fracture risk. A doctor can estimate this risk with a tool called FRAX.
Sources
- OrthoInfo (AAOS) - Osteoporosis
- MedlinePlus - Bone mineral density test
- NIAMS - Osteoporosis: Diagnosis, Treatment, and Steps to Take
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
