Osteoporosis is a disease in which your bones become weak and are likely to fracture (break). The disease can develop when your bone mineral density and bone mass decrease. It can also happen if the structure and strength of your bones change.

Osteoporosis is called a "silent" disease because it doesn't usually cause symptoms. You may not even know you have the disease until you break a bone. This could happen with any bone, but it's most common in the bones of your hip, vertebrae in the spine, and wrist.

Your bones are made of living tissue. To keep them strong, your body breaks down old bone and replaces it with new bone. Osteoporosis develops when more bone is broken down than replaced. You lose bone mass and changes happen in the structure of your bone tissue. This can happen as you get older. Other risk factors can also lead to the development of osteoporosis or increase your chance of developing the disease.

Anyone can develop osteoporosis, but you are more likely to develop it if you have one or more risk factors:

• Your sex. Osteoporosis is more common in women, especially after menopause (postmenopausal).
• Your age. Your risk increases as you get older. It is most common in people over age 50.
• Your body size. It is more common in people who are slim and thin boned.
• Your race:
  • White and Asian women are at highest risk.
  • African American and Mexican American women have a lower risk.
  • White men are at higher risk than African American and Mexican American men.
• Family history. Your risk of osteoporosis may be higher if one of your parents has osteoporosis or broke their hip.
• Changes to hormones. Low levels of certain hormones can increase your chance of developing osteoporosis.
• Diet. A diet that is low in calcium and/or vitamin D or does not include enough protein can raise your risk.
• Long-term use of certain medicines, such as:
  • Corticosteroids
  • Proton pump inhibitors (which treat GERD)
  • Medicines to treat epilepsy
• Having other medical conditions, such as:
  • Endocrine diseases
  • Certain digestive diseases
  • Rheumatoid arthritis
  • Certain types of cancer
  • HIV
  • Anorexia nervosa, a type of eating disorder
• Your lifestyle. Certain lifestyle factors can contribute to bone loss, such as:
  • Smoking tobacco
  • Long-term heavy alcohol use
  • Physical inactivity or prolonged periods of bedrest

Osteoporosis usually doesn't cause symptoms. You may not know that you have it until you break a bone.

Health care providers often diagnose osteoporosis during routine screening for the disease. The U.S. Preventive Services Task Force recommends screening for:

• Women age 65 and older
• Postmenopausal women under age 65 who have factors that increase the chance of developing osteoporosis

For men, it isn't clear yet whether regular screening is helpful. More research is needed to know for sure.

To find out if you have osteoporosis, your provider:

• Will ask about your medical history and whether you have ever broken a bone
• May do a physical exam, which could include checking for:
  • A loss of height and/or weight
  • Changes in your posture
  • Balance and gait (the way you walk)
  • Your muscle strength
• Will likely order a bone density scan
• May do a fracture risk assessment, which is a short questionnaire that helps estimate your risk of breaking a bone in the next 10 years
• Will likely order a bone density scan
• May do a fracture risk assessment, which is a short questionnaire that helps estimate your risk of breaking a bone in the next 10 years

The goals for treating osteoporosis are to slow or stop bone loss and to prevent fractures. Your provider may recommend:

• A healthy, balanced diet that includes enough calcium, vitamin D, and protein
• Lifestyle changes such as quitting smoking and limiting alcohol
• Regular physical activity including weight-bearing exercise (like walking), strength training, and balance exercises
• Fall prevention to help prevent fractures
• Medicines, such as:
  • Medicines that slow down bone loss
  • Medicines that help rebuild bone

In addition to managing your osteoporosis, it's important to avoid activities that may cause a fracture. These can include movements that involve:

• Twisting your spine, like swinging a golf club
• Bending forward from the waist, like sit ups and toe touches

You can also help reduce the risk of breaking a bone by preventing falls.

To help keep bones strong and help prevent osteoporosis, the best thing to do is to eat a healthy diet rich in calcium and vitamin D. Getting regular physical activity, limiting alcohol, and not smoking can also help.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Oxygen is a gas that your body needs to work properly. Your cells need oxygen to make energy. Your lungs absorb oxygen from the air you breathe. The oxygen enters your blood from your lungs and travels to your organs and body tissues.

Certain medical conditions can cause your blood oxygen levels to be too low. Low blood oxygen may make you feel short of breath, tired, and confused. It can also damage your body. Oxygen therapy can help you get more oxygen.

Oxygen therapy is a treatment that provides you with extra oxygen to breathe in. It is also called supplemental oxygen. It is only available through a prescription from your health care provider. You may get it in the hospital, another medical setting, or at home. Some people only need it for a short period of time. Others will need long-term oxygen therapy.

There are different types of devices that can give you oxygen. Some use tanks of liquid or gas oxygen. Others use an oxygen concentrator, which pulls oxygen out of the air. You will get the oxygen through a nose tube (cannula), a mask, or a tent. The extra oxygen is breathed in along with normal air.

There are portable versions of the tanks and oxygen concentrators. They can make it easier for you to move around while using your therapy.

You may need oxygen therapy if you have a condition that causes low blood oxygen, such as:

• COPD (chronic obstructive pulmonary disease)
• Pneumonia
• COVID-19
• A severe asthma attack
• Late-stage heart failure
• Cystic fibrosis
• Sleep apnea

Oxygen therapy is generally safe, but it can cause side effects. They include a dry or bloody nose, tiredness, and morning headaches.

Oxygen poses a fire risk, so you should never smoke or use flammable materials when using oxygen. If you use oxygen tanks, make sure your tank is secured and stays upright. If it falls and cracks or the top breaks off, the tank can fly like a missile.

Hyperbaric oxygen therapy (HBOT) is a different type of oxygen therapy. It involves breathing oxygen in a pressurized chamber or tube. That allows your lungs to gather up to three times more oxygen than you would get by breathing oxygen at normal air pressure. The extra oxygen moves through your blood and to your organs and body tissues.

HBOT is used to treat certain serious wounds, burns, injuries, and infections. It also treats air or gas embolisms (bubbles of air in your bloodstream), decompression sickness suffered by divers, and carbon monoxide poisoning.

But some treatment centers claim that HBOT can treat almost anything, including Alzheimer's disease, autism, cancer, and Lyme disease. The U.S. Food and Drug Administration (FDA) has not cleared or approved the use of HBOT for these conditions. There are risks to using HBOT, so always check with your provider before you try it.

Ozone is a gas. It can be good or bad, depending on where it is. "Good" ozone occurs naturally about 10 to 30 miles above the Earth's surface. It shields us from the sun's ultraviolet rays. Part of the good ozone layer is gone. Man-made chemicals have destroyed it. Without enough good ozone, people may get too much ultraviolet radiation. This may increase the risk of skin cancer, cataracts, and immune system problems.

"Bad" ozone is at ground level. It forms when pollutants from cars, factories, and other sources react chemically with sunlight. It is the main ingredient in smog. It is usually worst in the summer. Breathing bad ozone can be harmful. It can cause coughing, throat irritation, worsening of asthma, bronchitis, and emphysema. It can lead to permanent lung damage, if you are regularly exposed to it.

Environmental Protection Agency

Paget's disease of bone is a chronic bone disorder. Normally, there is a process in which your bones break down and then regrow. In Paget's disease, this process is abnormal. There is excessive breakdown and regrowth of bone. Because the bones regrow too quickly, they are bigger and softer than normal. They may be misshapen and easily fractured (broken). Paget's usually affects just one or a few bones.

Researchers do not know for sure what causes Paget's disease. Environmental factors may play a role. In some cases, the disease runs in families, and several genes have been linked to the disease.

The disease is more common in older people and those of northern European heritage. If you have a close relative who has Paget's, you are much more likely to have it.

Many people do not know that they have Paget's, because it often has no symptoms. When there are symptoms, they are similar to those of arthritis and other disorders. The symptoms include:

• Pain, which may be due to the disease or to arthritis, which can be a complication of Paget's
• Headaches and hearing loss, which can happen when Paget's disease affects the skull
• Pressure on the nerves, which can happen when Paget's disease affects the skull or spine
• Increased head size, bowing of a limb, or curvature of the spine. This can happen in advanced cases.
• Hip pain, if Paget's disease affects the pelvis or thighbone
• Damage to the cartilage of your joints, which may lead to arthritis

Usually, Paget's disease gets worse slowly over time. It does not spread to normal bones.

Paget's disease can lead to other complications, such as:

• Arthritis, because the misshapen bones can cause increased pressure and more wear and tear on the joints
• Heart failure. In severe Paget's disease, the heart has to work harder to pump blood to affected bones. Heart failure is more likely if you also have hardening of the arteries.
• Kidney stones, which can happen when the excessive breakdown of the bone leads to extra calcium in the body
• Nervous system problems, since the bones can cause pressure on the brain, spinal cord, or nerves. There may also be reduced blood flow to the brain and spinal cord.
• Osteosarcoma, cancer of the bone
• Loose teeth, if Paget's disease affects the facial bones
• Vision loss, if Paget's disease in the skull affects the nerves. This is rare.

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms
• A physical exam
• An x-ray of the affected bones. Paget's disease is almost always diagnosed using x-rays.
• An alkaline phosphatase blood test
• A bone scan

Sometimes the disease is found by accident when one of these tests is done for another reason.

To avoid complications, it is important to find and treat Paget's disease early. The treatments include:

• Medicines. There are several different medicines to treat Paget's disease. The most common type is bisphosphonates. They help reduce bone pain and stop or slow down the progress of the disease.
• Surgery is sometimes needed for certain complications of the disease. There are surgeries to
  • Allow fractures (broken bones) to heal in a better position
  • Replace joints such as the knee and hip when there is severe arthritis
  • Realign a deformed bone to reduce the pain in weight-bearing joints, especially the knees
  • Reduce pressure on a nerve, if enlargement of the skull or spine injuries effects the nervous system

Diet and exercise do not treat Paget's, but they can help to keep your skeleton healthy. If you do not have kidney stones, you should make sure to get enough calcium and vitamin D through your diet and supplements. Besides keeping your skeleton healthy, exercise can prevent weight gain and maintain the mobility of your joints. Talk with your health care provider before you start a new exercise program. You need to make sure that the exercise does not put too much stress on the affected bones.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Pain is a signal in your nervous system that something may be wrong. It is an unpleasant feeling, such as a prick, tingle, sting, burn, or ache. Each person feels pain differently, even if the reason for the pain is the same. Pain may be sharp or dull. It may be mild or severe. Pain may come and go, or it may be constant. You may feel pain in one area of your body, such as your back, abdomen, chest, or pelvis, or you may feel it all over.

Pain can help alert you that there is a problem. If you never felt pain, you might seriously hurt yourself without knowing it, or you might not realize you have a medical problem that needs treatment. Finding out what's causing your pain will help your health care provider determine the best way to manage or treat it.

Patterns and types of pain are named based on how long and how often you have pain. These include:

• Acute pain usually happens suddenly because of a disease, injury, or inflammation (irritation, redness, and/or swelling). This type of pain is often sharp and acts as a warning that something is wrong. It usually goes away when the cause is treated or healed, though sometimes it can turn into chronic pain. Some examples of causes of acute pain include broken bones or dental issues.
• Chronic pain lasts for longer than three months or the time in which you should have healed. It can affect all aspects of daily life, including your mood and relationships. Some conditions that might cause chronic pain include arthritis or back problems.
• Episodic pain can happen from time to time and may occur with long-term medical conditions. Some conditions that might cause episodic pain include sickle cell disease or chronic migraines.

Pain may also be categorized by what is likely to be the cause of the pain. Pain may be described as nociceptive (caused by tissue damage or inflammation), neuropathic (caused by nerve damage), or nociplastic (caused by changes in how your nervous system processes pain).

Understanding what causes pain and why people feel it differently may be difficult. Often, it's easier to find the cause of acute pain due to an injury than the cause of chronic pain, or you may have an ongoing cause of pain, such as cancer.

In some cases, there is no clear cause. Environmental factors and psychological factors such as stress and beliefs about pain may affect the way you feel pain and respond to treatment.

You are the only one who knows how your pain feels. Your provider can best measure your pain by how you report it. They may ask you:

• Where is the pain in your body?
• How long have you had the pain?
• How does the pain feel, such as stinging, burning, or sharp?
• How often do you have pain?
• When do you feel pain, such as in the morning, evening, or all the time?
• What relieves the pain?
• How does pain affect your daily life?
• Is the pain mild, moderate, or severe?
• To rate the pain on a scale.

If the cause of your pain is unknown, your provider may also do a physical exam and order blood tests or other medical tests to help find the cause.

Pain is not always curable, but there are many ways to manage and treat it. Treatment depends on the cause and type of pain. Treatments may include medicines, such as pain relievers. There are also non-drug treatments, such as acupuncture, physical therapy, and sometimes surgery.

Depending on the cause of your pain and your symptoms, your provider may recommend lifestyle changes. These may include suggestions for:

• Eating a healthy diet
• Adding exercise
• Losing weight
• Managing stress
• Improving mental health

NIH: National Institute of Neurological Disorders and Stroke