Hi Reader,

Last week, I had a cortisone shot in my left thumb CMC joint (the small joint at the base of the thumb). It's used in daily activities like opening jars and closing resealable bags (the worst), tying shoes, and holding a golf club. If you have arthritis in this joint, you know exactly what I am talking about.

The pain had become hard to ignore, especially as I spent more time at the driving range⛳. After breaking my wrist last summer, follow-up X-rays confirmed what I already suspected. In the radiologist’s words:
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​“Advanced degenerative changes in the 1st CMC joint, and to a lesser extent in the pisiform-triquetral joint.”

I was offered a cortisone shot when that report came back. I decided against it as I was busy healing my wrist, but this summer, the thumb started holding me back from some activities I wanted to do.

That is the time for intervention—when you stop doing something because of pain or fear.

As I scheduled the cortisone shot and had repeat X-rays, I started thinking about a question I’ve been asked many times — and one I think I can clarify:

Can you really have bone growth from arthritis and bone loss from osteopenia or osteoporosis at the same time?​

✅ Yes, You Can!

Many of my clients are surprised to learn that not only is this possible—it’s actually pretty common.

Let’s take a look at what’s happening in your bones and joints and how this might affect your DEXA scan results.

Osteoporosis and Osteopenia: What’s Happening?

• Osteoporosis is when bones lose minerals (like calcium) and become less dense, making them more susceptible to fractures.
• Osteopenia is a milder form of bone loss— bones are weaker than normal, but not as much as with osteoporosis.
• This bone loss occurs throughout the skeleton, especially in the spine, hips, and wrists.

Osteoarthritis (OA): What’s Happening?

• Osteoarthritis is a “wear and tear” condition of the joints, not the bones themselves.
• The cartilage (the smooth tissue covering the ends of bones in a joint) breaks down, which can lead to pain, swelling, and stiffness.
• As part of the body’s response, extra bone—called bone spurs or osteophytes—can form around the edges of joints, often in the knees, hips, and thumbs.

Can You Have Both? Yes!

• Osteoporosis and osteopenia affect the inside of bones, making them less dense and potentially more fragile.
• Osteoarthritis affects the joints and can cause extra bone growth on the outside edges of the joint.
• So, you can have thinner bones overall (osteoporosis/osteopenia) and, at the same time, have extra bone forming at the edges of your joints (osteoarthritis(OA)).
• These are two separate processes happening in different parts of your bones and joints, even though they can occur together.

How Osteoarthritis (OA) Affects DEXA scans

• If you have OA in your spine or hips, you may have extra bone growth (bone spurs) in those areas. These are the areas that a DEXA scan looks at for bone loss.
• These bone spurs make the bone look denser on the DEXA scan than it is.
• This can lead to a false reading—the scan might show your bones as more dense than they are because it’s measuring the extra bone from OA.
• As a result, osteoporosis or osteopenia may be underestimated. If this is the case, your DEXA report will most likely say something like:
  • "Degenerative changes are present in the lumbar spine, which may elevate bone mineral density measurements."
  • "Osteoarthritic changes (such as osteophytes or disc space narrowing) are noted in the lumbar spine, which may affect the accuracy of the DEXA results in this region."
  • "Results for the lumbar spine should be interpreted with caution due to the presence of degenerative disease/osteoarthritis."
  • "Elevated bone density in the spine may be due to degenerative changes rather than a true increase in bone mass."

One additional test I recommend requesting when scheduling your DEXA scan is the TBS score (Trabecular Bone Score). These numbers will help clarify results when arthritis may be skewing the picture. Check out the blog post I wrote about this.

So yes, I have both osteopenia and osteoarthritis, and it’s pretty common.

The good news?
​Exercise with progressively heavier weights is the recommended intervention for both of these conditions.

💪 Strong muscles unload your joints.
💪 Strong muscles also pull on and activate bones.
​WIN-WIN!

I hope you have found this helpful.

If you are not already working out with me in my live classes or subscribed to my Content Library, ->

Mark your calendar!

🧘‍♀️ The next Strong Women, Strong Bones Jumpstart begins Monday, Sept. 15​
✅ General registration opens from September 8th to 11th.

Stay tuned for early access announcements, and thank you for reading this far — you’re the best.

To strong bones and strong bodies,

The information provided is for general educational purposes only and is not intended to serve as medical or physical therapy advice to any individual. Please consult with your physician before starting any new exercise program. Any exercise has the potential to cause injury or physical problems.

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