Osteoporosis

Osteoporosis is a condition that causes your bones to become thinner and weaker than normal. This means that they can break easily, such as after a small bump or fall.

Key points

  1. Osteoporosis affects more than half of women and about one third of men over 60 years, as well as some younger people.
  2. Some people are more likely to get osteoporosis because they have risk factors, including family history, being very thin and long-term use of certain medicines.
  3. There are treatments that can slow the progression of osteoporosis and to help prevent you getting broken bones.
  4. Osteoporosis can be prevented by strengthening your bones. This can be achieved by keeping physically active, getting enough vitamin D and calcium in your diet and not smoking. 

Image credit: 123rf

What are the symptoms of osteoporosis?

One of the challenges with osteoporosis is that there are no early warning symptoms or signs. You may not know you have osteoporosis until you have:

  • a fracture of your wrist, hips, spine or other bones that happens more easily than it should
  • loss of height – as the vertebrae of your spine weaken they compress and the spine curves
  • with more severe osteoporosis, fractures that occur doing routine things like bending, lifting or just getting up from a chair – this happens because brittle bones have trouble supporting body weight. 

Who is at risk of osteoporosis?

Both men and women may have certain risk factors that can make them more likely to develop osteoporosis. Some of the risk factors that increase your likelihood of getting osteoporosis can't be changed, such as your gender or age, but many others can. See more at Can osteoporosis be prevented?

Risk factors for osteoporosis
  • Being female – women are at a greater risk of developing osteoporosis because of the rapid decline in oestrogen levels during menopause.
  • Increasing age – bones get thinner as you age.
  • A family history of osteoporosis or fractures.
  • Being very thin and unable to put on weight.
  • Long-term use of some medicines such as prednisone.
  • In women, irregular periods or early menopause, often caused by having your ovaries removed.
  • Being immobilised in bed for long periods.

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How is osteoporosis diagnosed?

Your doctor can assess your risk for osteoporosis from your medical history and by asking you about your lifestyle. Physical signs that you may have weak bones include:

  • previous fractures (often of your wrist, hip or spine)
  • a loss of height or stooping
  • a curved spine.

Your doctor may suggest you have a bone density scan (also called a DEXA scan) to check for bone weakness.

How is osteoporosis treated?

Treatment for osteoporosis will depend on the results of bone density scans, age, gender, medical history and severity of the condition. To help decide which treatment is suitable, you and your doctor may use a FRAX score. This shows your risk of having a fracture due to osteoporosis in the next 10 years. The FRAX score uses your risk factors for osteoporosis and the result of a bone density scan (DEXA) if you have had one. 

Treatment most commonly involves exercise to strengthen your bones and medicine that aims to increase bone density and reduce the risk of bone fracture. 

Exercise
Exercises that are good for people with osteoporosis include weight-bearing aerobics exercise, such as dancing, resistance training using free weights, such as elastic band resistance and body-weight resistance, and exercises to improve posture, balance and body strength, such as tai chi. Ideally, weekly physical activity should include something from all 3 groups.

Medication
Bisphosphonates such as alendronate and risedronate are the most common medicines for osteoporosis. Other medication options include hormone replacement therapy (HRT)raloxifeneteriparatide and denosumab. If you can't get enough calcium from a balanced diet, or have vitamin D deficiency, you may be prescribed calcium and vitamin D supplements to support your bone health while you are on osteoporosis treatment. 

Read more about treatment for osteoporosis.

Can osteoporosis be prevented?

Being aware of the risk factors you can change means that you can take steps to keep your bones healthy and strong, which will reduce the chance of osteoporosis developing.

Risk factors you can change Preventative action
Smoking
Diet low in calcium
  • The best sources of calcium are low-fat milk and milk products, as the calcium in milk is easily absorbed by your body.
  • Aim for 4 servings of low-fat dairy products a day.
  • Read more about calcium.
Low vitamin D levels
  • Vitamin D helps increase the absorption of calcium in food and optimises bone health and muscle function.
  • As little as 15 minutes in the sun (without sunscreen) 3 times a week enables your body to make enough vitamin D.
  • However, be sensible with your sun exposure as it increases your risks of skin cancer and make sure you never get sunburned. Read more about sensible sun exposure.
Being physically inactive or doing non-weight bearing exercise only
  • Aim to be physically active every day.
  • Include a range of strength-training exercises, weight-bearing aerobic activities and flexibility exercises.
  • Read more about physical activity.
Excessive alcohol
  • If you drink alcohol, aim to keep your drinking within the recommended limits for low-risk drinking. 
  • Read more about alcohol.

Read more on how to prevent osteoporosis.

Falls prevention

  • A fall at any age can be dangerous, but falls become increasingly common and far more likely to cause injury after the age of 55 years.
  • If you have osteoporosis, you are more likely to break a bone if you fall, and if you do you might need a long time to recover.
  • Learning how to prevent falls can help you avoid broken bones and the problems they can cause.

Read more about falls and falls prevention.

Learn more

All about osteoporosis Osteoporosis NZ
Osteoporosis and you Osteoporosis NZ
Preventing osteoporosis booklet
 Ministry of Health, NZ 
Osteoporosis and fractures Osteoporosis NZ

References

  1. Guidance on the diagnosis and management of osteoporosis in New Zealand Osteoporosis NZ
  2. Risedronate now fully subsidised – what is its place in practice? BPAC, NZ, 2013
  3. Bisphosphonates – addressing the duration conundrum BPAC, NZ, 2019
Credits: Health Navigator Editorial Team . Last reviewed: 09 Aug 2018