The first signal your bones send: osteopenia
October 20 is World Osteoporosis Day. Osteoporosis has no obvious symptoms in its early stage, so many people learn they have it only after a fracture. That is why a finding of 'osteopenia' on a health checkup is a first warning sign that should not be ignored.
What is osteopenia?
Osteopenia is the stage before osteoporosis, a state in which bone density is lower than normal but has not yet reached the criteria for osteoporosis. It is classified by the T-score of a bone density test as follows.
| T-score | Diagnosis |
|---|---|
| -1.0 or above | Normal |
| Below -1.0 and above -2.5 | Osteopenia |
| -2.5 or below | Osteoporosis |
Not all osteopenia progresses to osteoporosis. But bone density outside the normal range means the bones have begun to weaken. Even with the same osteopenia, fracture risk differs greatly with age and the risk factors below.
- A history of fracture
- A family history of hip fracture in a parent
- Long-term steroid use
- Coexisting conditions such as rheumatoid arthritis
- Smoking and drinking
What to check after the diagnosis
Look back at past fractures. If you have ever broken a wrist, spine or hip just from falling from standing height (a fragility fracture), it should not be written off as a simple accident. Even if bone density is in the osteopenia range, a confirmed fragility fracture of the spine or hip allows a diagnosis of osteoporosis and treatment, and medication is also considered when fracture risk is high.
Look at the trend in bone density. A single T-score shows only the present state. The amount of decline compared with earlier tests, menopausal status, medications and coexisting conditions should be reviewed together. Results differ with the equipment and the site measured, so rather than fretting over changes in the decimal point, it is better to set the timing of follow-up tests according to your individual risk.
Prevention in daily life
- Diet: rather than relying on a single calcium supplement, eat a balanced diet that includes calcium, vitamin D and good-quality protein.
- Exercise: steadily combine weight-bearing exercise such as walking with strength and balance exercise.
- Preventing falls: in older people, not falling is as important as strengthening the bones. Clear away slippery floors, thresholds and dim lighting, and be especially careful in wet bathrooms.
In closing
Osteopenia is not a result that says 'it's not osteoporosis yet, so it's fine'; it is closer to a preliminary warning that you must manage the risk of osteoporosis and fractures going forward. Rather than treating after a fracture, checking risk factors and protecting the bones from the osteopenia stage is the starting point of lifelong bone health.
This article summarizes a piece I contributed to Bridge Economy [Expert Column], “The first signal your bones send, 'osteopenia'… do strength exercise and check bone density” (October 13, 2026; in Korean): link.
This article is general information. Interpreting bone density results and whether to treat depend on age, fracture history and coexisting conditions, so please confirm through an examination.
References
- Nam HS. [Expert Column] The first signal your bones send, 'osteopenia'… do strength exercise and check bone density (in Korean). Bridge Economy. October 13, 2026.