Osteoporosis is a condition where bone strength is compromised due to a decrease in bone density that occurs over time. A reduction in bone quality can result in fractures happening more easily, even during minimal impact.

How common is osteoporosis?

Osteoporosis is very common, with an estimated three million people living with the condition in the UK. It is thought that over half a million people are seen in hospital for osteoporosis-related fractures each year.

Who is most at risk of developing the condition?

Post-menopausal women and women who have undergone a hysterectomy are most likely to be diagnosed with osteoporosis, but it can affect both men and women of all ages.

Those with a family history of the condition may be more likely to go on to develop it.

Lifestyle can also play a part in the development of the condition; drinking alcohol, smoking and having a low BMI can also increase a person’s risk.

Certain health conditions that can lead to an increased risk in secondary osteoporosis developing. These include:

  • rheumatoid arthritis
  • asthma
  • endocrine disorders
  • some blood disorders
  • Crohn’s
  • and coeliac disease

Certain types of medication can also make someone more prone to developing osteoporosis, including:

  • some steroid medications
  • immunosuppressants
  • antacids
  • lithium
  • proton pump inhibitors
  • aromatase inhibitors
  • certain antipsychotics
  • some antiepileptics and anticonvulsants
  • methotrexate
  • and thyroid hormone treatment.

It is likely that your doctor will discuss the risk posed by these medications before you commence a course.

If you have concerns about a medication you should speak to your doctor. Do not alter your treatment plan without consulting with your doctor or specialist first.

What symptoms can osteoporosis cause?

Many osteoporosis cases go undiagnosed until a fracture occurs. This is because the reduction in bone strength tends to happen gradually and does not usually cause any noticeable symptoms.

The most common types of fractures seen in people with osteoporosis are those which occur at the wrists, hips and spine. These type of fractures can result in the need for surgery.

If your doctor suspects that you might have osteoporosis they may use an online assessment tool to calculate your risk factor. FRAX and Q-Fracture are two frequently used examples.

Your doctor may also want to arrange a bone density scan, known as a densitometry x-ray scan, or a DEXA.

This measures the amount of bone mineral in a particular area of your skeleton. Your results are then compared to a healthy adult of the same age to calculate a ‘standard deviation’. A result which is below the SD by 2.5 or more is classed as osteoporosis. Your bone density is categorised as decreasing if you receive a score of -1 to -2.5; this range is referred to as osteopenia. Anything above -1 is considered normal.

Are there any treatments for osteoporosis?

There is no cure for osteoporosis. There are a number of drug treatments that can help to slow down the deterioration of the bones, such as bisphosphonates, or strontium ranelate.

Which treatment is issued may depend on whether or not the patient has already had a fracture (referred to as primary or secondary prevention).

Preventing falls and maintaining good general health are recommended for patients with osteoporosis, or at risk of developing the condition.

  • Those at risk of osteoporosis should lead an active lifestyle which incorporates regular exercise, including a mixture of aerobic, weight bearing and resistance exercises.
  • A healthy and balanced diet is important for maintaining strong bones.
  • Smokers should try to quit their habit and heavy drinkers should reduce their alcohol intake, as these can have a detrimental effect on bone density.
  • Vitamin D is a crucial component when it comes to bone health. In the UK it can be difficult to obtain sufficient amounts of vitamin D from sunlight and diet alone. Recent advice from the Scientific Advisory Committee on Nutrition (SACN) states that adults should consider taking a vitamin D supplement throughout the year.
  • Keep a clear and hazard-free home to reduce the chances of a fall. Check for trip hazards such as loose carpets or floorboards. Make sure that you are aware of your surroundings and wear glasses or contact lenses at all times.

Living with osteoporosis

If you are diagnosed with osteoporosis it does not mean that you will go on to break a bone, but it is important to take care of your general health and minimise the risk of falls and bumps.

As we have already mentioned, anyone diagnosed with the condition should continue to lead an active lifestyle. Most people will therefore be able to carry on working as normal. However, if your job poses a significant fall risk then you might need to speak to your employer about making some changes.

Your GP will be able to offer advice and support on living with the condition. You can also visit the National Osteoporosis Society site for more information.