osteoporosis risk reduction

Overview

Osteoporosis is a bone disease that makes your bones weak and more likely to break. It develops slowly over many years and is often called a 'silent condition' because you cannot feel your bones getting weaker.

Yes, it is very common. Globally, about one in three women and one in five men over 50 will experience a fracture caused by osteoporosis.

Osteoporosis can affect anyone, but it is most common in women after the menopause, and in older men. Younger people can also be affected if they have certain medical conditions or take certain medicines.

Symptoms

Common symptoms

• Usually there are no symptoms until a bone breaks.
• A broken bone after a minor bump or fall.
• Back pain caused by a cracked or collapsed vertebra.
• Loss of height and a stooped or curved posture.

Symptoms in children

• Osteoporosis is rare in children, but signs may include bone pain, difficulty walking, and fractures that happen easily.

Symptoms in older adults

• Broken bones in the hip, wrist, or spine.
• New or worsening back pain.
• Reduced height or a bent forward posture.

Causes

Main causes

• Bone is living tissue that is constantly being broken down and rebuilt.
• After about age 30, bone loss begins to outpace new bone building.
• After the menopause, estrogen levels drop, which speeds up bone loss.
• Low calcium intake, vitamin D deficiency, and a sedentary lifestyle can contribute.

Risk factors

• Being female, especially after the menopause.
• Being older than 50.
• Having a family history of osteoporosis or broken bones.
• Having a small, thin body frame.
• Long-term use of certain medicines, such as corticosteroids.
• Smoking and drinking too much alcohol.

When to see a doctor

See a doctor urgently if:

• If you have a sudden severe pain in your back or leg after a fall, seek medical help immediately.
• If you have broken a bone from a minor bump or fall, get it checked out.

Book a routine appointment if:

• If you are over 50 and have risk factors, ask your doctor about bone health.
• If you have a parent who broke a hip, it is worth discussing bone density testing.
• If you have lost height or developed a stooped posture, see a doctor.

Diagnosis

A bone density scan is the main test used to diagnose osteoporosis. It is a painless scan that measures how strong and dense your bones are.

Tests that may be done

• Bone density scan (DEXA scan) of your spine, hip, or wrist.
• Blood tests to check calcium, vitamin D, thyroid, and kidney function.

What to expect at your appointment

You will lie on a flat scanning table while a scanner moves over parts of your body. It is quick, painless, and usually takes 10 to 20 minutes. The results give you a T-score, which tells you if your bone density is normal, low, or at the level of osteoporosis.

Treatment

Treatment aims to strengthen your bones, slow bone loss, and prevent breaks. It combines lifestyle changes, nutrition, and sometimes medication.

Self-care at home

• Make sure you are getting enough calcium and vitamin D.
• Do regular weight-bearing exercises like walking, dancing, or stair climbing.
• Do muscle-strengthening exercises twice a week.
• Quit smoking and limit alcohol.
• Remove fall hazards in your home, such as loose rugs.

Medical treatments

There are several types of medicines that can slow bone thinning and lower fracture risk. Your doctor will talk to you about the options that fit your health needs and explain how each one works. These may be given as tablets, injections, or through a drip.

When is surgery considered?

Surgery is not a routine treatment for osteoporosis itself. It is only used to repair a broken bone, such as a hip fracture, with pins, plates, or a joint replacement.

Living with this condition

Take steps to avoid falls. Keep your home clear of clutter, wear non-slip shoes, use a night light, and have your eyes checked regularly. Use a walking aid if recommended.

Lifestyle tips

• Stay active with exercises that are safe for you.
• Eat a balanced diet rich in calcium and vitamin D.
• Avoid smoking and heavy drinking.
• Talk to a physiotherapist about a safe exercise plan.

Diet and exercise

Eat foods like dairy products, leafy green vegetables, fortified cereals, and oily fish. Gentle sunlight helps your body make vitamin D, but in some climates you may need a supplement. Ask your doctor or pharmacist what is right for you.

Mental health and emotional wellbeing

Living with osteoporosis can make some people feel anxious about falling and breaking a bone. This can lead to avoiding social activities. It is normal to feel this way. Talk to your doctor, family, or a counsellor about your worries.

Prevention

You can reduce your risk of developing osteoporosis at any age. Eating well, staying active, not smoking, and limiting alcohol make a big difference.

Vaccines

Getting your recommended vaccinations, such as flu and COVID-19 vaccines, can help you avoid illnesses that leave you weak and at higher risk of falls.

Screening programmes

If you are 50 or older and have risk factors, talk to your doctor about a bone density scan. Some health services offer this routinely after a certain age.

Complications

If left untreated

• Fractures of the hip, spine, or wrist that can happen from a minor fall.
• Spine fractures can cause severe back pain, height loss, and a curving spine.
• A hip fracture can lead to surgery, disability, and loss of independence.

Long-term outlook

With the right care, many people with osteoporosis live active and independent lives. Treatment can greatly reduce your chance of a fracture, and even small changes in bone density lower your risk.

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