The Osteoporosis/PsA Link—and How to Protect Your Bones

by Casey Nilsson Patient Advocate

For decades, researchers have waffled on the connection between psoriatic arthritis and osteoporosis — when the body doesn’t produce enough bone tissue, which results in fractures — and its less-severe form, osteopenia. New studies offers insight about the link and how we might protect our bones. Read on for the science behind the connection, plus ways to prevent bone fractures in the future.

Comparing research.

The Northwestern study: A cross-sectional analysis

In June of 2017, researchers at Northwestern University published a cross-sectional analysis of data from the 2006–2012 National Emergency Department Sample in the Journal of the American Academy of Dermatology. Their study pool included 198,102,435 total children and adults —183,725 with psoriasis and 28,765 with psoriatic arthritis.


Psoriatic arthritis and osteoporosis

Patients with psoriasis had significantly higher odds of osteopenia or osteoporosis, however the statistical association between psoriatic arthritis and osteoporosis/osteopenia was observed at an even higher rate. In total, 4.5 percent of people with psoriatic arthritis had osteoporosis compared to .81 percent of the healthy control — a 455 percent increase.

Doctor showing a patient an x-ray.

Psoriatic arthritis and osteopenia

Patients with psoriatic arthritis also experienced a greater incidence of osteopenia, a less severe form of bone density loss where bones are weak but aren’t breaking easily: .99 percent versus .16 percent in the control, a 518 percent increase.

Man with pelvic pain.

Common bone damage for psoriatic arthritis

For psoriatic arthritis, the most common documented bone damage due to osteoporosis was stress fractures, with additional vertebral, pelvic, femoral, and tibial/fibular fractures noted.

Injection drug.

What’s causing the damage?

Some studies point to overuse of corticosteroids, a common anti-inflammatory treatment for psoriatic arthritis and other diseases, which can slow the regeneration of bone tissue in the body. But another study, published in 2001 in the Journal of Rheumatology, controlled for corticosteroid use and still found that patients with psoriatic arthritis had significantly lower bone mineral density than their non-psoriatic peers.

Doctor talking to a patient.

Corticosteroids and the risk of osteoporosis/osteopenia

The bottom line: If you’ve used corticosteroids — in pill form or via injection — for more than three months, you’re at risk of developing osteoporosis or osteopenia. Talk to your doctor about exploring the next step in treatment.

Weight-bearing exercises.

Weight-bearing exercises – a preventative measure

If you’ve been hit with joint damage, weight-bearing exercises can help you strengthen your bones. Check out these four low-impact exercises to help strengthen your skeleton and read these do’s and don’ts for exercising for bone health.

Soy milk and soy beans.

Vitamins and nutrients to protect your bones

Calcium — and vitamin D to help with absorption — are also important for bone health. Make sure you’re getting at least 1,000 milligrams of calcium per day, plus 600 international units of vitamin D per day, either through dietary supplements or food including milk, orange juice with calcium, soybeans, and fish like as sardines or salmon. Magnesium could help keep your bones strong, too.

Bone density scans.

Bone density scans

Most people don’t know they have osteoporosis until they experience a bone fracture. Talk to your doctor about a bone density scan or, if you’ve already had one, ask for regular scans to keep an eye on your risk of injury.

Casey Nilsson
Meet Our Writer
Casey Nilsson

Casey Nilsson, an award-winning journalist and magazine editor based in Rhode Island, writes about autoimmune disease for HealthCentral. Casey is a 2018 Association of Health Care Journalists fellow, and her reporting on unfair labor conditions for people with disabilities was a finalist for the City and Regional Magazine Association Awards. Diagnosed with psoriatic arthritis in 2016, Casey enjoys digging into rheumatologic news, research and trends.