Preparing for bone density

Overview

A bone density test (also called a DXA scan) is a simple, painless scan that measures the strength of your bones. It helps doctors find out if your bones are becoming weak and thin (osteoporosis), which can increase the risk of breaking a bone.

Yes, bone density tests are a standard, safe procedure for people who have risk factors for osteoporosis or who have already had a fracture after a minor bump or fall.

The test is most often recommended for women over 65, men over 70, and anyone who has risk factors such as a family history of osteoporosis, long-term steroid use, or early menopause.

Symptoms

Common symptoms

• A bone density test itself does not cause symptoms. It is usually done if you have risk factors or have had a fracture from a minor injury.

Symptoms in children

• If a child needs this test, it is very rare and only for specific conditions (like long-term steroid use or eating disorders). No preparation is needed, but the child should avoid calcium supplements before the scan.

Symptoms in older adults

• The test is common for older adults who may have lost height, developed a stooped posture, or had a fracture after a low-impact fall.

Causes

Main causes

• A bone density test is performed to check for low bone mass, which can be caused by aging, hormonal changes (especially after menopause), or certain medical conditions.
• The test helps diagnose osteoporosis before a fracture occurs.

Risk factors

• Being over 65 (women) or 70 (men)
• Early menopause (before age 45)
• Long-term use of steroid medicines (such as prednisone)
• Family history of osteoporosis or hip fracture
• Low body weight or a history of eating disorders
• Smoking or heavy alcohol use
• Rheumatoid arthritis or other inflammatory conditions

When to see a doctor

See a doctor urgently if:

• If you have a sudden, sharp back pain that started after a minor injury or even without cause – this could be a spinal fracture.

Book a routine appointment if:

• If you are a woman over 65 or a man over 70 and have never had a bone density test.
• If you have any of the risk factors listed above and are younger than the screening age, talk to your doctor about whether a scan is right for you.

Diagnosis

A bone density test (DXA scan) is the standard way to measure bone strength. Your doctor may also calculate your risk of fracture using a tool called FRAX, which combines your scan results with other factors.

Tests that may be done

• DXA scan (dual-energy X-ray absorptiometry) – your main test.
• FRAX score – a risk calculator your doctor may use alongside your scan.
• Sometimes a blood test to check for other causes of bone loss.

What to expect at your appointment

You will lie on a padded table, fully clothed (no metal zippers or buttons). A scanner arm passes over your hip and spine. It is painless and takes 10–20 minutes. You may be asked to hold your breath for a few seconds. After the scan, a radiologist reads the images and sends a report to your doctor.

Treatment

If your bone density test shows low bone mass (osteoporosis or osteopenia), your doctor will talk with you about ways to protect your bones. Treatment is individualised and may include lifestyle changes and, in some cases, medicines that help slow bone loss or build new bone.

Self-care at home

• Get enough calcium and vitamin D from food or supplements as recommended by your doctor.
• Do weight-bearing exercises like walking, dancing, or climbing stairs.
• Do resistance exercises like lifting light weights or using resistance bands.
• Avoid smoking and limit alcohol to no more than one drink per day (for women) or two (for men).

Medical treatments

Your doctor may prescribe a type of medicine called a bisphosphonate or other bone-strengthening medication. These are usually taken as a tablet once a week or once a month, or given as an injection. Some people may need hormone-related therapies. Always take these exactly as prescribed and tell your doctor about any side effects.

When is surgery considered?

Surgery is not used for low bone density itself. However, if you have a hip or spinal fracture due to weak bones, you may need surgery to repair the break.

Living with this condition

If you have low bone density, small changes can help you stay active and safe. Focus on fall prevention: remove loose rugs, keep rooms well-lit, wear sturdy shoes, and use handrails on stairs. Let your doctor know if you feel unsteady on your feet.

Lifestyle tips

• Stay physically active with exercises that are gentle on your joints, like tai chi or swimming.
• Get enough calcium (through dairy, leafy greens, or fortified foods) and vitamin D (from sunlight or supplements as advised).
• Talk to your doctor before starting a new exercise programme.

Diet and exercise

A balanced diet rich in calcium (milk, yoghurt, cheese, broccoli, almonds) and vitamin D (oily fish, eggs, fortified cereals) supports bone health. Weight-bearing exercise – like brisk walking, jogging, or tennis – helps strengthen bones. Aim for 30 minutes on most days, as your doctor advises.

Mental health and emotional wellbeing

Finding out you have low bone density can be worrying. It is natural to feel anxious about fractures. Remember that with good management, most people with osteoporosis can live full, active lives. Talk to your doctor or a counsellor if you feel overwhelmed.

Prevention

You can reduce your risk of developing low bone density by eating a healthy diet with enough calcium and vitamin D, doing regular weight-bearing exercise, not smoking, and limiting alcohol. These steps also help prevent bone loss if you already have low bone density.

Screening programmes

Routine screening with a bone density test is recommended for women 65 and older, and men 70 and older. Younger people with risk factors may also be screened. Discuss with your doctor when you should start.

Complications

If left untreated

• Increased risk of fractures, especially in the hip, spine, and wrist.
• Spinal fractures can lead to height loss, chronic back pain, and a hunched posture.
• Hip fractures often require surgery and can affect your ability to live independently.

Long-term outlook

With early detection and proper management, most people with low bone density can prevent fractures and maintain an active lifestyle. Treatments are effective, and small daily habits make a big difference. You are not alone – many resources are available to help you stay strong and safe.

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