The Differences Between Osteoporosis & Osteoarthritis

Exploring the similarities and differences between osteoporosis and osteoarthritis.

Osteoporosis and osteoarthritis are two common health conditions that affect older adults, and can lead to a number of symptoms and health complications. Here, we are exploring what these conditions might mean for older adults, the key differences between them, the causes and risk factors, how both are diagnosed and treated, how to prevent them from developing, how to manage them in daily life, and the emotional and physical support caregivers can provide. At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about medical conditions in ageing adults, we can help. 

What is osteoarthritis? 

Osteoarthritis is the most common form of arthritis, and is considered a degenerative joint disease that causes the protective cartilage that cushions the joints to wear down over time. Mostly this affects weight-bearing joints like the knees, hips and spine, but it can also affect other joints such as the hands. As cartilage deteriorates, bones start to rub against each other which can cause pain, tenderness, stiffness and swelling around the joints. As a result, a person with osteoarthritis may experience decreased range of motion in the affected joints and reduced mobility. Joints can feel stiff, particularly after long periods of inactivity or sleep, and they can sometimes feel swollen or inflamed. Osteoarthritis can cause bone spurs to develop, which are small bony growths that can further limit joint movement. Those with osteoarthritis may also feel a sensation like bones are grating together, and this is known as crepitus. One lesser known symptom of osteoarthritis is sleep disturbance, with around 70% of those with the condition experiencing some sort of sleep issue, such as trouble falling or staying asleep, or insomnia.Osteoarthritis is thought to be most common in older adults. However, factors such as joint injuries, obesity, and genetics can influence their health and increase their risk of developing the condition, no matter what age they are.

What are the main differences between osteoporosis and osteoarthritis? 

With similar sounding names and some overlapping symptoms, it may be difficult for some people to distinguish between osteoarthritis and osteoporosis, but an accurate diagnosis is important in order to get the relevant treatment, support, and make the appropriate lifestyle changes. While the two conditions affect the musculoskeletal system, some of the key differences between osteoporosis and osteoarthritis include:

• Structural differences: One of the most stark differences is that osteoarthritis is a joint disease, meaning it impacts the mechanism that joins two bones together and allows them to move. This usually affects weight-bearing joints like the knees, hips, and spine. On the other hand, osteoporosis is a bone disease that affects the bones themselves. 
• Symptom differences: In osteoarthritis, the cartilage within joints wears down over time and causes pain, stiffness and reduced mobility after moving, whereas osteoporosis affects the strength and density of bones, and therefore may not produce any symptoms at all until a fracture occurs. If any symptoms do occur, these could include back pain or height loss.
• Causes and risk factors: Osteoarthritis is typically caused by wear and tear on the joints, ageing, obesity, or a previous injury, while in osteoporosis, the risk factors include ageing, hormonal changes (especially in postmenopausal women) and nutritional deficiencies such as a lack of calcium or vitamin D.
• Impact on daily life: Both conditions can have a huge impact on daily life, however osteoarthritis tends to limit movement due to joint pain, and so could cause the most obvious symptoms, whereas osteoporosis may not produce any noticeable symptoms, but can increase the risk of fractures which can have a negative impact on an older person. Studies on people with osteoporosis found that physical and social function was reduced due to an increased risk of fractures, while studies on people with osteoarthritis suggest pain management as a cornerstone for improving their quality of life.

How are osteoporosis and osteoarthritis diagnosed? 

The diagnosis of either osteoarthritis or osteoporosis requires a comprehensive medical evaluation to determine the symptoms and signs, the risk factors, the potential causes, and more. For osteoporosis, a doctor might seek to do bone density tests such as a DEXA scan to measure your bone strength, find out their condition and density, and assess your risk for fractures. For osteoarthritis, the joints are the focus, so your doctor may suggest you have an X-ray, MRI scan and/or a physical examination to reveal any joint damage. Blood tests can also help to rule out other causes of joint pain that could be coming from underlying conditions. Getting an early diagnosis of either condition is extremely important so your doctor can begin regularly monitoring the progression of your symptoms, if any, and recommending treatments and lifestyle changes in order to potentially slow the progression, alleviate some of the painful symptoms, and potentially avoid bone fractures in those with osteoporosis. By doing so, an older person may notice a significant improvement in their quality of life due to pain reduction, enhanced mobility, and improved mental health due to less worry over falls and potential fractures. 

How are osteoporosis and osteoarthritis treated? 

An accurate diagnosis leads to treatment options that can have a significantly positive impact on the lives of older adults who suffer from the symptoms of these conditions each day. Treatment options for osteoporosis focus on strengthening bones and preventing fractures, and these might include:

• Taking calcium and vitamin D supplements if deficient in these vitamins and minerals 
• Taking bisphosphonates to slow bone loss
• Starting hormone therapy (for women) if your doctor feels this could help 
• Improving bone strength and balance through regular weight-bearing exercises to reduce fall risk 
• In severe cases, surgical options such as vertebroplasty can help to relieve pain 

Treatment options for osteoarthritis focus on managing pain and improving joint function, and these might include:

• Pain relief medications such as non-steroidal anti-inflammatory drugs (NSAIDs), codeine, topical creams or steroid injections 
• Physiotherapy to strengthen muscles surrounding the joints to provide more support – a physiotherapist may also suggest assistive devices, footwear changes, and other ways to relieve your symptoms  
• Lifestyle modifications including weight management and gentle exercises such as swimming or walking to reduce joint strain and improve mobility
• For knee pain, you may be offered nerve treatment to help quell pain 
• In severe cases, joint replacement surgery or joint fusing can provide relief

Neither of these conditions can be cured, so both will require long-term treatment to manage pain, improve mobility, and maintain quality of life.

Are there ways to prevent osteoporosis or osteoarthritis? 

While genetics can play a role in whether or not someone develops osteoarthritis or osteoporosis as they age, living a healthy lifestyle is the best way to prevent both of these conditions from forming later in life. To prevent osteoporosis, it can help to focus on maintaining strong bones by ensuring you get enough calcium in your diet, and enough vitamin D from the sun on a regular basis. You can also get these from supplements if you do not get enough in daily life, and you will find more information on this in our guide to the best supplements and vitamins for older adults.Also, starting a routine of regular resistance or weight-bearing exercises has been found to help preserve bone health and muscle mass. This could be something as simple as walking, or a more regimented routine of weight training to strengthen the muscles around your bones and offer added protection for any falls that could otherwise result in fractures. Lastly, it is beneficial to avoid smoking and drinking excessive amounts of alcohol in order to remain as healthy as possible. This can support your overall health, but studies have found that quitting smoking could help to increase the bone mass previously lost from smoking.To prevent osteoarthritis, maintaining a healthy weight is key as this can reduce the strain on your joints. Research has found that maintaining a healthy weight can support overall health and reduce the risks of lowered bone mineral density. It also helps to start doing regular low-impact exercises such as swimming or cycling which have been found to help people with osteoarthritis as they don’t overstrain the joints and provide more stability. This can also help to reduce wear on your joints. Preventing joint injuries can be done by practising good posture in everyday life, and using proper body mechanics to reduce your risk of developing osteoarthritis.You can learn more about exercise for older adults in our guide to fitness and exercise for older adults.

How can older adults manage osteoporosis and osteoarthritis? 

The same tips for preventing osteoporosis and osteoarthritis are helpful for the management of both conditions. In addition to these, it can help to use adaptive devices, mobility aids and home adaptations to maintain mobility while managing pain and discomfort. These can also make moving around more comfortable for those with osteoarthritis who have joint pain, and make it safer for those with osteoporosis who are more likely to suffer from a fracture. Home adaptations might include things like installing grab bars, non-slip mats and raised seating to make daily activities safer and reduce strain on joints. You can learn more about home adaptations in our guide to home adaptations for disabled older people.Simple changes like using a walking stick or walker for extra support, or wearing shock-absorbing footwear could also make a difference and help to maintain mobility and balance. For older adults who are managing the symptoms of osteoporosis or osteoarthritis, they may also find that stress management techniques such as meditation or deep breathing could help to relieve the stress associated with these conditions.

What emotional support is often needed for osteoporosis and osteoarthritis?

Much of managing osteoarthritis is about pain management, but the psychological and emotional elements of this can be challenging, and may require support from loved ones, doctors, and professional carers alike. Similarly, those who live with osteoporosis may not have painful symptoms, but could suffer from the psychological and emotional impact of being fearful of falling or having any accidents that could lead to a debilitating fracture due to a loss of bone density. It is important to address the emotional impact of living with both of these chronic conditions, as they can lead to feelings of frustration, isolation and anxiety, particularly for older adults who rely on loved ones or caregivers for help. Chronic pain and reduced mobility may also affect daily activities, and contribute to depression or a sense of losing control of their body. Offering regular encouragement and providing a listening ear can really help older people to cope with these emotions, so if you are caring for someone who suffers from osteoporosis or osteoarthritis, spend time with them and give them space to discuss how they feel. You could also suggest support groups or therapy that could provide a space to share experiences. Keep things positive by helping individuals to set realistic goals for their physical activity, and celebrate small victories that boost self-esteem and provide motivation during difficult times.

How can caregivers support older adults with osteoporosis or osteoarthritis?

Living with osteoporosis or osteoarthritis can be challenging for an older adult, and they may require support from caregivers who can assist with pain management, encourage their adherence to any treatments prescribed by their doctor, and help with daily activities to maintain their quality of life. Caregivers can facilitate exercise that improves strength and mobility while being mindful of joint safety in those with osteoarthritis. Also, they can assist with home modifications, such as organising the installation of grab bars and ensuring the environment is safe and set up to prevent falls. As well as physical and practical support, caregivers can provide emotional support and a listening ear, while facilitating doctor visits to help older adults manage these conditions on a long-term basis. Caregivers and people with osteoporosis may find more useful information through the Royal Osteoporosis Society, the NHS, and Age UK. For those with osteoarthritis and their caregivers, more information can be found through Versus Arthritis, the NHS, and Arthritis Action. Domiciliary services with a home carer from Home Instead can provide:

• Companionship to help with the emotional support side of caring for someone with these conditions 
• Home help and housekeeping to keep on top of daily cleaning and organising chores when mobility is impaired
• Personal care services if daily washing and dressing becomes too painful or dangerous due to the symptoms of osteoarthritis or osteoporosis 
• Respite care to give family caregivers a regular break from caring duties 
• Specialist arthritis and mobility care for those living with osteoarthritis or osteoporosis 

At Home Instead, we understand there’s no place like home, so our home care offering aims to help older adults retain independence and stay in familiar surroundings. We offer a number of bespoke services which can be tailored to your needs, and our Care Professionals are highly trained to deliver the individualised service you need. Reach out to the team at Home Instead to learn more.