preventing osteoporosis

Overview

Osteoporosis means 'porous bone.' It is a disease that makes your bones weak and more likely to break. Healthy bone looks a bit like a honeycomb. When you have osteoporosis, the holes in the honeycomb get bigger, so the inside of the bone becomes less dense and fragile.

Yes, osteoporosis is very common, especially as people get older. Worldwide, about one in three women and one in five men over the age of 50 will have a fracture caused by osteoporosis at some point in their lives.

Osteoporosis can affect anyone, but it is most common in women after menopause. Men can get it too, especially when they are older. People with certain risk factors, such as a family history, a low body weight, or some medical conditions, are also more likely to develop it.

Symptoms

Common symptoms

• There are no symptoms in the early stages, before bones have weakened a lot.
• A fracture from a small bump or fall — often in the hip, wrist, or spine.
• Back pain from a collapsed vertebra (bone in the spine).
• Gradual loss of height or a stooped posture.

Symptoms in children

• Children rarely have osteoporosis. If it happens, it is usually linked to another medical condition, so the child might have bone pain, fractures from minor injuries, or slower growth. Healthy eating and physical activity during childhood are the best ways to build strong bones for later in life.

Symptoms in older adults

• A bone that breaks more easily than expected.
• Back pain that may be sudden or comes on slowly, sometimes after a minor movement like bending or sneezing.
• Losing height (more than 2 cm or about 1 inch) without a known cause.
• A curved or hunched posture that is new.

Causes

Main causes

• Getting older, when bone naturally gets weaker.
• Hormone changes, such as lower estrogen in women after menopause or lower testosterone in men.
• Not getting enough calcium or vitamin D over many years.
• Lack of weight-bearing exercise, which helps bones stay dense.
• Other health conditions or medicines that affect bone strength.

Risk factors

• Being over 50, or especially over 70.
• Being female, especially after menopause or after removal of the ovaries.
• Having a small, thin frame or being underweight.
• Family history of osteoporosis or broken hip.
• Smoking or drinking too much alcohol.
• Taking certain medicines long-term, like oral steroids (corticosteroids).
• Medical conditions like rheumatoid arthritis, thyroid disease, or eating disorders.
• A history of fractures after age 50.

When to see a doctor

See a doctor urgently if:

• If you fall and have severe pain, or you think you may have broken a bone, seek medical care right away.
• If you have sudden back pain plus numbness or weakness in your legs, go to the emergency department.

Book a routine appointment if:

• Talk to your doctor about your bone health if you are over 50, have gone through menopause, have had a fracture after age 50, or have family members with osteoporosis.
• Ask about a bone density test if you are 65 or older, or younger if you have risk factors.
• If you are taking medicines that can weaken bones, like steroids, ask your doctor what you can do to protect them.

Diagnosis

Osteoporosis is diagnosed through a special X-ray test that measures bone density. This tells your doctor how thick and strong your bones are compared to a healthy young adult's bones.

Tests that may be done

• DEXA (dual-energy X-ray absorptiometry) scan — the most common test. It is painless and takes about 15 minutes.
• FRAX score — a tool your doctor can use to estimate your risk of breaking a bone in the next 10 years.
• Blood tests — sometimes used to look for medical conditions that may cause bone loss.

What to expect at your appointment

You will lie on a padded table while an X-ray scanner passes over your lower spine and hip. You stay fully clothed and do not need any preparation. After the scan, a doctor will explain your bone density numbers, your fracture risk, and what you can do to protect your bones.

Treatment

Treatment for osteoporosis aims to slow down bone loss, keep your bones as strong as possible, and prevent fractures. It includes lifestyle changes, making sure you get the right nutrients, and, when needed, taking medication.

Self-care at home

• Eat foods and drinks rich in calcium, like dairy, leafy greens, and fortified plant milks.
• Get enough vitamin D — from safe sun exposure or as recommended by your doctor — because your body needs it to absorb calcium.
• Do regular weight-bearing exercises like walking, dancing, hiking, or climbing stairs, plus muscle-strengthening exercises.
• Avoid smoking and limit alcohol to no more than a drink or two per day.
• Prevent falls by keeping your home tidy, using non-slip mats, and wearing sturdy shoes.

Medical treatments

There are several types of medications that can help protect bones. They work by either slowing down bone breakdown or helping your body build new bone. Which medication is right for you depends on your age, health, and fracture risk. Your doctor will talk through the benefits and risks, and it is important to take any treatment exactly as prescribed. Always talk to your healthcare provider before starting or stopping any medicine.

When is surgery considered?

Surgery is not a treatment for osteoporosis itself. It is sometimes needed for a broken hip or a broken bone in the spine that causes severe pain or mobility problems. Surgery helps repair the bone, relieve pain, and make it possible to get back to your normal activities more quickly.

Living with this condition

The main goal is to stay safe and keep your bones as healthy as possible. This means preventing falls: use a non-slip mat in the bath, remove loose rugs, keep hallways clear, and turn on lights at night. Wear supportive shoes, and if you need a cane or walker, use it. Also, be careful when bending, lifting, or reaching up, especially with heavy objects.

Lifestyle tips

• Keep moving every day — try to stay active for at least 30 minutes on most days.
• Try balance exercises like tai chi, standing on one foot, or gentle yoga.
• Move heavy items close to your body, and avoid sudden twisting of your spine.
• Ask your doctor or pharmacist to review your medicines to see if any can cause dizziness. That can help prevent falls.

Diet and exercise

Aim for a balanced diet with plenty of calcium and protein. Good calcium sources include yogurt, milk, cheese, broccoli, kale, tofu, and fortified plant drinks. Vitamin D helps your body use calcium, but it is hard to get enough from food alone — your doctor can advise whether a supplement is right for you. For exercise, include weight-bearing activities like brisk walking, jogging, tennis, or stair climbing, and add muscle-strengthening exercises with resistance bands, light weights, or body weight. Your physiotherapist or doctor can help design a safe exercise routine.

Mental health and emotional wellbeing

Living with osteoporosis can feel frustrating and scary. You might worry about falling or breaking a bone. These feelings are normal. It helps to talk to family, friends, or a counselor. Managing stress, keeping up with hobbies, and staying connected with people you enjoy can also lift your mood.

Prevention

You can do a lot to prevent osteoporosis or slow it down. The key is to build strong bones when you are young and keeping them strong as you age. Getting enough calcium and vitamin D, exercising regularly, avoiding smoking and heavy drinking, and managing health conditions can all help. Even if you already have osteoporosis, the same steps can slow further bone loss and reduce fracture risk.

Screening programmes

Bone density screening is a way to catch osteoporosis before you break a bone. It is recommended for all women aged 65 and older, and for men aged 70 and older. Younger people may need screening earlier if they have risk factors like earlier fractures, certain medicines, or family history. Ask your doctor whether and when you should be screened.

Complications

If left untreated

• Bone fractures from minor bumps or falls — most commonly in the hip, wrist, or spine.
• Hip fractures that can require major surgery and long recovery.
• Spinal fractures that can cause back pain, height loss, and a curved spine.
• Loss of independence because a fracture may make it hard to do daily tasks.
• In older adults, a serious fracture can raise the risk of other health problems.

Long-term outlook

With good medical care and lifestyle habits, you can protect your bones and prevent many fractures. Even if you already have osteoporosis, treatments and exercise can slow down bone loss, and in some people, even improve bone density. Most people with osteoporosis continue to live active, full lives. Take it one step at a time, and lean on your healthcare team for guidance.

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