The Osteoporosis-RA Connection


Paige Greenfield

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Research has found that people with rheumatoid arthritis (RA) are more likely to develop osteoporosis, a condition in which bones become less dense and more likely to fracture.

Here are some reasons these two conditions may be connected:

  • Medication: Many people with RA take a type of medication called a glucocorticoid. Examples include prednisone (such as Deltasone and Orasone), prednisolone (Prelone), dexamethasone (Decadron and Hexadrol), and cortisone (Cortone Acetate). These medications help reduce inflammation and suppress the immune system. However, these drugs interfere with healthy bone metabolism and can lead to bone loss.

  • Inactivity: When you're in pain or lose joint function because of RA, walking and other forms of exercise become difficult to do. However, physical activity is essential for maintaining strong bones. Lack of physical activity is a risk factor for osteoporosis.

  • RA itself: Bone loss can occur due to RA. The areas surrounding the joints that RA has affected are most likely to lose bone.

How to keep your bones strong

At Your Appointment

Questions to Ask About Osteoporosis

Having RA doesn't mean you'll automatically develop osteoporosis. Here are steps you can take to ward off the disease:

  • Consider supplements. If you take glucocorticoid medication, also take daily calcium and vitamin D supplements. You may need at least 1,000 to 1,200 mg of calcium and 400 to 1,000 IU of vitamin D daily. Ask your physician how much is right for you.

  • Exercise. Weight-bearing activities, such as walking and weight training, are best for healthy bones. Exercise can also maintain joint mobility and improve your balance and flexibility, which reduce your risk of falling and fracturing a bone.

  • Quit smoking. The tobacco habit can interfere with your body's ability to absorb calcium from food.

  • Ask about testing. Talk with your doctor about whether a bone density test is right for you. For appropriate individuals, the test helps assess the risk for osteoporosis or detect the condition before it causes a bone fracture.

Medications help manage osteoporosis

If you've been diagnosed with osteoporosis, there are several types of medications to treat the disease. These drugs may slow or stop bone loss, or even help rebuild bone. However, like most medications, they can cause side effects. One class of osteoporosis medications, called bisphosphonates, has been associated with a rare type of thigh bone fracture. If you take bisphosphonates, tell your doctor if you feel an unusual ache or pain in your hip or thigh, which could indicate that something is wrong. Still, bisphosphonates have been shown to reduce the risk of fractures caused by osteoporosis. Speak with your doctor about the possible risks of these and any other medications you take, and be sure to let him or her know if you experience any abnormal symptoms.

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The Osteoporosis-RA Connection

People with RA are more likely to develop osteoporosis, a condition in which bones become less dense and more likely to fracture.
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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Apr 28, 2017

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Medical References

  1. Possible Fracture Risk With Osteoporosis Drugs. FDA.
  2. Arthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases.
  3. What People with Rheumatoid Arthritis Need to Know About Osteoporosis. National Institute of Arthritis and Musculoskeletal and Skin Diseases.
  4. Osteoporosis Medicines: What You Need to Know. National Osteoporosis Foundation.
  5. Glucocorticoid-Induced Osteoporosis. American College of Rheumatology.

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