Osteoporosis

Symptoms of osteoporosis 

Osteoporosis develops slowly over several years.

There are often no warning signs or symptoms until a minor fall or a sudden impact causes a bone fracture.

Healthy bones should be able to withstand a fall from standing height, so a bone that breaks in these circumstances is known as a fragility fracture.

The most common injuries in people with osteoporosis are:

• wrist fractures
• hip fractures 
• fractures of the spinal bones (vertebrae)

Osteoporosis isn't painful of itself. However, when a fracture occurs, there can be pain after breaking a bone.

Diagnosing osteoporosis 

If your doctor suspects you have osteoporosis, by assessing your symptoms and risk factors for developing it, they may refer you for a scan to measure your bone mineral density.

This type of scan is known as a DEXA (DXA) scan. It's a short, painless procedure, and your bone density can then be used to assess your risk of developing fractures.

Treating osteoporosis 

Treatment for osteoporosis is based on:

• treating and preventing fractures
• using medication to reduce the rate of reduction of bone density that occurs naturally as you get older

The decision about what treatment you have, if any, will depend on your risk of fracture. This will be based on a number of factors, such as your age and the results of your DXA scan.

Your GP will discuss treatment options with you, and whether medication will benefit you. However, you should make sure you have a healthy diet, keeping enough levels of calcium and vitamin D, to help maintain the strength of your bones.

You can ask for advice from your GP or practice nurse about your diet, and they may recommend making changes or taking supplements.

Preventing falls and fractures

The key messages for older people and their family and carers are:

• falls are a risk as you get older, but aren't inevitable – there are measures you can take to prevent falls or reduce the harm that might be caused by falling
• staying active and healthy – for example, through exercise and diet – is likely to keep you independent and reduce your risk of falling
• if you're unsteady on your feet or fall, speak to your GP so possible causes, such as poor eyesight, certain medications, and poor muscle strength and balance, can be identified and treated

Causes of osteoporosis

Bones are at their thickest and strongest in your early adult life. Their density increases until your late 20s. But you gradually start losing bone density from about the age of 35.

This happens to everyone, but some people develop osteoporosis, and lose bone density much faster than normal. This means they are at greater risk of a fracture.

Women are more at risk of developing osteoporosis than men because the hormone changes that occur in the menopause directly affect bone density.

Other factors that increase your risk of developing osteoporosis include:

• inflammatory conditions, such as rheumatoid arthritis, Crohn's disease and chronic obstructive pulmonary disorder (COPD)
• conditions that affect the hormone-producing glands, such as an overactive thyroid gland (hyperthyroidism) or an overactive parathyroid gland (hyperparathyroidism)
• a family history of osteoporosis, particularly history of a hip fracture in a parent  
• long-term use of certain medications that affect bone strength or hormone levels, such as oral prednisolone
• malabsorption problems
• heavy drinking and smoking

Preventing osteoporosis 

If you're at risk of developing osteoporosis, you should take steps to help keep your bones healthy. This may include:

• taking regular exercise
• healthy eating, eating a balanced diet which includes foods rich in calcium and vitamin D
• making lifestyle changes, such as stopping smoking and reducing how much alcohol you drink

Living with osteoporosis 

If you're diagnosed with osteoporosis, there are steps you can take to reduce your chances of a fall, such as removing hazards from your home and having regular sight tests and hearing tests.

Speak to your GP or nurse if you have any questions.

• Osteoporosis.

More useful links

• National Osteoporosis Society
• Long Term Conditions Alliance Northern Ireland
• How to use your health services