osteoporosis specialist tests overview

Overview

Osteoporosis is a condition that makes your bones weak and more likely to break. It is sometimes called a ‘silent disease’ because you might not know you have it until a bone breaks.

Yes, osteoporosis is very common, especially in people over the age of 50. Worldwide, millions of people have osteoporosis.

It most often affects women after menopause, but men and younger people can also develop it. Risk increases with age.

Symptoms

Common symptoms

• No symptoms until a fracture occurs.
• Back pain caused by a fractured or collapsed vertebra.
• Loss of height over time.
• Stooped posture (sometimes called a dowager’s hump).

Symptoms in children

• Osteoporosis in children is rare and usually linked to another medical condition or medication.
• Symptoms may include bone pain, fractures from minor falls, or delayed growth.

Symptoms in older adults

• Fractures from low-impact falls, such as a fall from standing height.
• Hip, wrist, or spine fractures that happen easily.
• Sudden severe back pain that may signal a spine fracture.

Causes

Main causes

• Age-related bone loss – bones naturally become thinner as you get older.
• Low levels of sex hormones, especially oestrogen in women after menopause and testosterone in men.
• Not enough calcium or vitamin D in your diet over a long time.

Risk factors

• Family history of osteoporosis or hip fractures.
• Being underweight or having a small body frame.
• Smoking tobacco or drinking too much alcohol.
• Long-term use of certain medicines, such as corticosteroid tablets.
• Certain medical conditions like rheumatoid arthritis, thyroid problems, or disorders that affect nutrient absorption.

When to see a doctor

See a doctor urgently if:

• If you think you have a bone fracture after a fall or minor injury – go to the emergency department or call your local emergency number.
• If you have sudden severe back pain that makes it hard to move or stand.

Book a routine appointment if:

• If you are a woman over 65 or a man over 70 – it is a good idea to talk to your doctor about bone health screening.
• If you have a family history of osteoporosis or have broken a bone easily in the past.
• If you have risk factors such as long-term steroid use, early menopause, or a low body weight.

Diagnosis

Your doctor will ask about your medical history, risk factors, and any fractures. The main test for diagnosing osteoporosis is a bone density scan.

Tests that may be done

• Bone density scan (also called DXA or DEXA) – a low-dose X-ray that measures bone strength at the hip and spine.
• FRAX score – a tool that uses your bone density and risk factors to estimate your 10-year chance of a fracture.
• Blood tests – to check for other conditions that can cause bone loss, such as vitamin D deficiency or thyroid problems.

What to expect at your appointment

During a DXA scan, you lie on a padded table while a scanner arm passes over your body. It is completely painless and takes about 10 to 20 minutes. The amount of radiation is very low – lower than a standard chest X-ray.

Treatment

Treatment for osteoporosis aims to slow bone loss, strengthen bones, and prevent fractures. Your doctor will recommend a plan based on your bone density, age, and overall health.

Self-care at home

• Get enough calcium and vitamin D through your diet or supplements (talk to your doctor before starting any supplement).
• Do regular weight‑bearing exercises like walking, dancing, or climbing stairs.
• Build muscle strength with resistance exercises (e.g., using light weights or resistance bands).
• Take steps to prevent falls – remove tripping hazards at home, wear sturdy shoes, and have your eyesight checked.

Medical treatments

Doctors may prescribe medications that help slow bone loss or increase bone formation. These include drugs from classes such as bisphosphonates, selective oestrogen receptor modulators (SERMs), and monoclonal antibody therapies. Some people may also benefit from hormone replacement therapy (HRT) around menopause. Your healthcare provider will explain the options and choose the safest one for you.

When is surgery considered?

Surgery is not a treatment for osteoporosis itself, but it may be needed to repair a broken bone, such as hip replacement after a hip fracture or vertebroplasty for a spine fracture.

Living with this condition

Living with osteoporosis means taking care to avoid falls and protect your bones. This includes using handrails, keeping pathways clear, and wearing supportive shoes. It may also mean modifying activities that could cause a fall.

Lifestyle tips

• Stay active with exercises that are safe for your bones – your doctor or physiotherapist can help you choose the right activities.
• Quit smoking and limit alcohol to protect bone health.
• Maintain a healthy body weight – being too thin raises your risk.

Diet and exercise

Eat a diet rich in calcium (dairy products, leafy greens, fortified foods) and vitamin D (oily fish, eggs, fortified milk). Regular weight‑bearing exercise like brisk walking and strength training helps keep bones strong.

Mental health and emotional wellbeing

Osteoporosis can cause worry about falling or breaking a bone. This anxiety may lead some people to avoid activities they enjoy. It is normal to feel frustrated or fearful, but staying connected and getting support can make a big difference. If you feel very anxious or depressed, talk to your doctor or a mental health professional. If you are in crisis, please reach out to a crisis support service.

Prevention

You cannot always prevent osteoporosis, but you can reduce your risk by eating a healthy diet with enough calcium and vitamin D, staying physically active, avoiding smoking, and limiting alcohol. If you are at high risk, your doctor may recommend earlier screening.

Screening programmes

Bone density screening is recommended for women aged 65 and older, and for younger women or men with risk factors. Talk to your doctor about whether screening is right for you.

Complications

If left untreated

• Fractures of the hip, spine, wrist, or other bones from minor falls or even everyday activities.
• Chronic pain from vertebral fractures.
• Loss of height and a curved spine (kyphosis) that can affect breathing and digestion.
• Reduced mobility and independence after a hip fracture.

Long-term outlook

With early diagnosis and proper management, most people with osteoporosis can live active, full lives and avoid serious fractures. Treatment can slow bone loss, strengthen bones, and greatly reduce fracture risk. It is never too late to take steps to protect your bones.

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