What is osteoporosis?
Osteoporosis occurs when our bones become weak because they are less dense. This often happens as we get older, and can result in broken bones, usually in the wrist, hip or spine. One in two women and one in five men in the UK over the age of 50 will break a bone, usually due to osteoporosis, so the condition is very common.
What are the signs of osteoporosis?
Osteoporosis does not usually have any signs or obvious symptoms. In most cases the first sign of the disease is a fracture or broken bone after a minor bump or fall or even after a strain such as picking up something heavy.
This condition can result in tiny fractures in the spine, which can lead to a reduction in height over time, curvature of the spine or ongoing back pain.
What causes osteoporosis?
Healthy bone is made up of a thick outer shell and a strong inner honeycomb mesh of bone tissue. This tissue is made up of protein and minerals including calcium. This tissue is continuously broken down and replaced with new cells to keep our bones healthy. As we get older we lose more bone tissue lost than we create, so our bones become weaker.
Reduced levels of oestrogen accelerate the breakdown of bone tissue. That is why more women than men suffer the disease, especially following the menopause.
Who is most at risk?
You have a greater risk of developing osteoporosis if you:
- Have already suffered a break or fracture resulting from a minor bump, strain or fall
- Are over 50
- Have gone through early menopause (before the age of 45)
- Have had your ovaries removed (before the age of 45)
- Have a history of missed periods
- Are on long-term corticosteroid medication
- Have a family history of osteoporosis or fractures
- Have low levels of calcium and vitamin
- Have digestive disorders that affect nutrient absorption
How is osteoporosis diagnosed?
If you are at risk of osteoporosis the only way to check if you have the disease, or are likely to develop it, is to have a scan, which scans your bones. The best screening test is a DEXA scan. Other tests for bone density include ultrasound and CT scanning.
The DEXA scan
DEXA stands for dual energy X-ray absorptiometry. The scan is quick, simple and painless and it measures the density of your bones, most often in the wrist, hip or spine.
You may be diagnosed as having osteopenia. This result isn’t serious, but it means your bone density is lower than normal and you may be more likely to develop osteoporosis in the future. A DEXA scan can then be used over time to accurately monitor any changes over time in your bone density.
The following can help build healthy bones:
- Eating calcium-rich foods including dairy products and green, leafy vegetables
- Getting enough vitamin D in your diet, which is essential for absorbing calcium. Vitamin D is found in foods such as milk, eggs and oily fish
- Bone-building exercise such as jogging, aerobics, tennis, dancing, brisk walking and weight lifting, and low-impact exercise such as swimming, gardening, walking or playing golf
- Avoiding smoking as this can reduce your bone density
- Avoiding drinking alcohol as this damages our skeleton and increases the risk of fracture
- Avoiding drinking too much caffeine as this may affect the balance of calcium in the body
- Always check your doctor first before taking up any vigorous exercise.
What treatment is available?
If you already have osteoporosis there are many treatments that can help to prevent fractures and strengthen bones, such as:
- Biophosphonates – drugs that block the breakdown of bone tissue
- Selective oestrogen receptor modulators (SERMs) – these drugs mimic oestrogen
- Calcitonin – a hormone produced by your thyroid gland, which blocks the action of the cells that break down bone. It is usually taken as a nasal spray
- Calcium and vitamin D, which can reduce bone loss. Post-menopausal women should take between 700 and 1000mg a day in their diet, or as a supplement
- Exercising – can reduce fractures even if osteoporosis is present by reducing bone loss, strengthening muscles and maintaining mobility
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For more information about these drugs, including details of side effects, speak to your doctor. Your doctor will advise you which drugs are appropriate for you.