Osteoporosis risk screening

Overview

Osteoporosis is a condition that makes your bones weak and more likely to break. It happens when your body loses too much bone or makes too little new bone. Think of your bones like a brick wall — over time, the bricks become thin and brittle.

Yes, osteoporosis is very common. Around 1 in 3 women and 1 in 5 men over age 50 will have a broken bone because of it.

It can affect anyone, but you are at higher risk if you are female, over 65, have a family history, or have low body weight.

Symptoms

Common symptoms

• Osteoporosis usually has no symptoms until a bone breaks. Some people notice a gradual loss of height or a curved back (sometimes called a 'dowager's hump').
• Back pain from a collapsed or fractured vertebra (a small bone in your spine).

Symptoms in children

• Osteoporosis is rare in children. If it happens, it may cause bone pain, difficulty walking, or fractures from minor falls.

Symptoms in older adults

• Broken bones, especially in the hip, wrist, or spine, after a minor fall or bump.
• Loss of height over time.
• A stooped posture.

Causes

Main causes

• Normal aging — bones become thinner as you get older.
• Hormonal changes, such as lower estrogen after menopause in women or low testosterone in men.
• Not enough calcium and vitamin D in your diet over a long time.

Risk factors

• Being female, especially if you went through early menopause (before age 45).
• Family history of osteoporosis or hip fracture.
• Long-term use of certain medications, such as steroids (corticosteroids).
• Low body weight (BMI below 19).
• Smoking or drinking too much alcohol.
• Certain medical conditions like rheumatoid arthritis or thyroid problems.

When to see a doctor

See a doctor urgently if:

• If you have a sudden, severe back pain or a fall that might cause a broken bone.

Book a routine appointment if:

• If you are a woman age 65 or older, or a man age 70 or older, talk to your doctor about screening.
• If you are younger but have risk factors (like a parent who broke a hip, or if you smoke).
• If you have broken a bone after a minor bump or fall after age 50.

Diagnosis

Doctors use a bone density test (called DXA or DEXA scan) to measure how strong your bones are. It is a simple, painless X-ray that takes about 10 to 15 minutes.

Tests that may be done

• Dual-energy X-ray absorptiometry (DXA) scan — the main test for osteoporosis.
• A FRAX score (Fracture Risk Assessment Tool) — your doctor may use this to estimate your risk of breaking a bone in the next 10 years.
• Blood or urine tests to rule out other causes of bone loss, such as vitamin D deficiency.

What to expect at your appointment

You will lie on a padded table while a scanner passes over your lower back and hip. It does not hurt. You do not need to undress, but avoid wearing clothes with metal zippers or buttons. The test gives a T-score that compares your bone density to that of a healthy young adult. Your doctor will explain the results and what they mean for you.

Treatment

Treatment aims to slow bone loss, strengthen bones, and prevent breaks. It usually involves a combination of healthy habits, medications, and sometimes physical therapy.

Self-care at home

• Eat a balanced diet rich in calcium (dairy, leafy greens, fortified foods) and vitamin D (sunlight, fatty fish, supplements if needed).
• Do weight-bearing exercises like walking, jogging, dancing, or climbing stairs — with your doctor's OK.
• Do strength training exercises to build muscle and support your bones.
• Avoid smoking and limit alcohol to no more than 1-2 drinks per day.
• Take steps to prevent falls — remove rugs, improve lighting, wear sturdy shoes.

Medical treatments

Your doctor may prescribe medications that help slow bone loss or build new bone. These are usually tablets taken weekly or monthly, or injections given every few months or once a year. Always follow your doctor's advice — never stop or change treatment without talking to them. Calcium and vitamin D supplements may also be recommended if your diet is low.

When is surgery considered?

Surgery is not used to treat osteoporosis itself, but it may be needed to repair a broken bone, such as a hip fracture. In some cases, a procedure called vertebroplasty (injecting bone cement into a fractured spine bone) might be considered if pain is severe and does not improve with other treatments.

Living with this condition

Living with osteoporosis means being careful but not afraid. You can still enjoy life, travel, and stay active. Focus on fall-proofing your home, wearing supportive shoes, and staying strong with exercise. Listen to your body and avoid heavy lifting or risky activities.

Lifestyle tips

• Do regular, gentle exercise like walking, tai chi, or swimming to keep your balance and strength.
• Get enough calcium and vitamin D every day — ask your doctor about supplements if needed.
• Check your home for trip hazards — loose rugs, cords, or poor lighting.
• Get your eyes checked regularly to ensure good vision and reduce fall risk.

Diet and exercise

A bone-friendly diet includes plenty of calcium (milk, yogurt, cheese, broccoli, almonds, tofu) and vitamin D (sunshine, oily fish, fortified cereals). Avoid too much salt, caffeine, and soda, which can weaken bones. For exercise, aim for 30 minutes of weight-bearing activity most days, plus muscle-strengthening exercises twice a week. Always check with your doctor before starting a new exercise program.

Mental health and emotional wellbeing

Osteoporosis can cause worry about falls and fractures, which may lead to anxiety or depression. It is normal to feel this way. Talking to a counselor, joining a support group, or sharing concerns with your doctor can help. Staying active and connected with others is good for your mood.

Prevention

You can lower your risk by building strong bones from childhood and maintaining them through life. Eat well, exercise, avoid smoking, and limit alcohol. If you have risk factors, talk to your doctor about screening early. It is never too late to take steps for healthier bones.

Screening programmes

Screening for osteoporosis is recommended for all women age 65 and older, and for younger adults with risk factors. The main test is a bone density scan. Talk to your healthcare provider about when you should be screened.

Complications

If left untreated

• Broken bones, especially in the hip, spine, or wrist — these can cause lasting pain, disability, and loss of independence.
• Hip fractures often require surgery and can make it hard to walk or live alone.
• Spine fractures can lead to height loss, a curved back, and chronic back pain.

Long-term outlook

With early detection and proper care, most people with osteoporosis can lead full, active lives and avoid serious breaks. Treatment is effective and can strengthen bones. Stay positive — many people manage osteoporosis well and continue doing what they love.

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