Content Supplied by NHS Choices

Brittle bones

Osteoporosis is a condition that affects the bones, causing them to become weak and fragile and more likely to break (fracture).

Osteoporosis is a condition that weakens bones, making them fragile and more likely to break.

It's a fairly common condition that affects around three million people in the UK. More than 300,000 people receive hospital treatment for fragility fractures (fractures that occur from standing height or less) every year as a result of osteoporosis.

Wrist fractures, hip fractures and fractures of the vertebrae (bones in the spine) are the most common type of breaks that affect people with osteoporosis. However, they can also occur in other bones, such as in the arm, ribs or pelvis.

There are usually no warnings you've developed osteoporosis and it's often only diagnosed when a bone is fractured after even minor falls.

Read more about the symptoms of osteoporosis.

What causes osteoporosis?

During childhood, bones grow and repair very quickly, but this process slows as you get older.

Bones stop growing in length between the ages of 16 and 18, but continue to increase in density until you're in your late 20s.

You gradually start to lose bone density from about 35 years of age. Women lose bone rapidly in the first few years after the menopause (when monthly periods stop and the ovaries stop producing an egg).

Losing bone is a normal part of the ageing process, but for some people it can lead to osteoporosis and an increased risk of fractures.

Other factors that increase your risk of developing osteoporosis include:

Read more about the causes of osteoporosis.

Diagnosing osteoporosis

If your doctor suspects you have osteoporosis, they can make an assessment using an online programme, such as FRAX or Q-Fracture. They may also 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 mineral density can then be used to assess your fracture risk.

Read more about diagnosing osteoporosis.

Treating osteoporosis

Treatment for osteoporosis is based on treating and preventing fractures and using medication to strengthen bones.

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.

Read more about how osteoporosis is treated.

Preventing osteoporosis

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

Read more about preventing osteoporosis.

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.

To help you recover from a fracture, you can try using:

Speak to your GP or nurse if you're worried about living with a long-term condition. They may be able to answer any questions you have.

You may also find it helpful to talk to a trained counsellor or psychologist or other people with the condition.

The National Osteoporosis Society can put you in touch with local support groups, and they also have an online discussion forum.

Read more about living with osteoporosis.

Content Supplied by NHS Choices

Brittle bones

Osteoporosis is caused by bones losing their density, either through age or other factors. Some people are more at risk of developing osteoporosis than others.

Osteoporosis causes bones to become less dense and more fragile. Some people are more at risk than others.

Bones are at their thickest and strongest in your early adult life and their density increases until your late 20s. But you gradually start losing bone density from around 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.

Risk groups

Osteoporosis can affect men and women. It's more common in older people, but it can also affect younger people.

Women

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

The female hormone oestrogen is essential for healthy bones. After the menopause (when monthly periods stop), oestrogen levels fall. This can lead to a rapid decrease in bone density.

Women are at even greater risk of developing osteoporosis if they have:

  • an early menopause (before 45 years of age)
  • hysterectomy (removal of the womb) before the age of 45, particularly when the ovaries are also removed
  • absent periods for more than six months as a result of overexercising or too much dieting

Men

In most cases, the cause of osteoporosis in men is unknown. However, there's a link to the male hormone testosterone, which helps keep the bones healthy.

Men continue producing testosterone into old age, but the risk of osteoporosis is increased in men with low levels of testosterone.

In around half of men, the exact cause of low testosterone levels is unknown, but known causes include:

  • the use of certain medications, such as oral glucocorticoids
  • alcohol misuse
  • hypogonadism (a condition that causes abnormally low testosterone levels)

Risk factors

Many hormones in the body can affect the process of bone turnover. If you have a condition of the hormone-producing glands, you may have a higher risk of developing osteoporosis.

Hormone-related conditions that can trigger osteoporosis include:

  • hyperthyroidism (overactive thyroid gland)
  • disorders of the adrenal glands, such as Cushing's syndrome
  • reduced amounts of sex hormones (oestrogen and testosterone)
  • disorders of the pituitary gland
  • hyperparathyroidism (overactivity of the parathyroid glands)

Other risk factors

Other factors thought to increase the risk of osteoporosis and broken bones include:

You can read more about who is at risk of osteoporosis and broken bones on the National Osteoporosis Society website.

Content Supplied by NHS Choices

Brittle bones

Osteoporosis is often diagnosed after a fracture caused by weakened bones. You may have a DEXA (DXA) scan to measure your bone mineral density.

Osteoporosis is often diagnosed after weakened bones have led to a fracture.

If you're at risk of developing osteoporosis, your GP may refer you for a bone mineral density scan, known as a dual energy X-ray absorptiometry (DEXA, or DXA) scan.

Normal X-rays are a useful way of identifying fractures, but they aren't a reliable method of measuring bone density.

DEXA (DXA) scan

DEXA scan can be used to help diagnose osteoporosis. It's a quick, safe and painless procedure that usually takes about five minutes, depending on the part of the body being scanned.

The scan measures your bone mineral density and compares it to the bone mineral density of a healthy young adult and someone who's the same age and sex as you.

The difference between the density of your bones and that of a healthy young adult is calculated as a standard deviation (SD) and is called a T score.

Standard deviation is a measure of variability based on an average or expected value. A T score of:

  • above -1 SD is normal 
  • between -1 and -2.5 SD is defined as decreased bone mineral density compared with peak bone mass
  • below -2.5 is defined as osteoporosis

Although a bone density scan can help diagnose osteoporosis, your bone mineral density result isn't the only factor that determines your risk of fracturing a bone.

Your age, sex and any previous injuries will need to be taken into consideration before deciding whether you need treatment for osteoporosis.

Your doctor can help you take positive steps to improve your bone health. If you need treatment, they can also suggest the safest and most effective treatment plan for you. 

Content Supplied by NHS Choices

Brittle bones

Leading a healthy lifestyle is the best way to delay the onset of osteoporosis and slow the rate at which your bones become fragile.

Your genes are responsible for determining your height and the strength of your skeleton, but lifestyle factors such as diet and exercise influence how healthy your bones are.

Regular exercise

Regular exercise is essential. Adults aged 19 to 64 should do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling or fast walking, every week.

Weight-bearing exercise and resistance exercise are particularly important for improving bone density and helping to prevent osteoporosis.

As well as aerobic exercise, adults aged 19 to 64 should also do muscle-strengthening activities on two or more days a week by working all the major muscle groups, including the legs, hips, back, abdomen, chest, shoulders and arms.

If you've been diagnosed with osteoporosis, it's a good idea to talk to your GP or health specialist before starting a new exercise programme to make sure it's right for you.

Read more about the physical activity guidelines for adults and find out more about:

Weight-bearing exercises

Weight-bearing exercises are exercises where your feet and legs support your weight. High-impact weight-bearing exercises, such as running, skipping, dancing, aerobics, and even jumping up and down on the spot, are all useful ways to strengthen your muscles, ligaments and joints.

When exercising, wear footwear that provides your ankles and feet with adequate support, such as trainers or walking boots.

Read more about choosing sports shoes and trainers.

People over the age of 60 can also benefit from regular weight-bearing exercise. This can include brisk walking, keep-fit classes or a game of tennis. Swimming and cycling aren't weight-bearing exercises, however.

Read more about the physical activity guidelines for older adults.

Resistance exercises

Resistance exercises use muscle strength, where the action of the tendons pulling on the bones boosts bone strength. Examples include press-ups, weightlifting or using weight equipment at a gym.

If you've recently joined a gym or haven't been for a while, your gym will probably offer you an induction. This involves being shown how to use the equipment and having exercise techniques recommended to you.

Always ask an instructor for help if you're not sure how to use a piece of gym equipment or how to do a particular exercise.

Read more about exercise and bone health.

Healthy eating

Eating a healthy balanced diet is recommended for everyone. It can help prevent many serious health conditions, including heart diseasediabetes and many forms of cancer, as well as osteoporosis.

Calcium is important for maintaining strong bones. The recommended intake of calcium is at least 700mg a day. This is about the equivalent of one pint of milk.

Calcium can also be found in a number of different foods, including leafy green vegetables, dried fruit, tofu and yoghurt.

Vitamin D is also important for healthy bones and teeth because it helps your body absorb calcium. Vitamin D can be found in eggsmilk and oily fish.

However, most vitamin D is made in the skin in response to sunlight. Short exposure to sunlight without wearing sunscreen (10 minutes twice a day) throughout the summer should provide you with enough vitamin D for the whole year.

Certain groups of people may be at risk of not getting enough vitamin D. These include:

  • people who are housebound or particularly frail
  • people with a poor diet
  • people who keep covered up in sunlight because they wear total sun block or adhere to a certain dress code
  • women who are pregnant or breastfeeding

If you're at risk of not getting enough vitamin D through your diet or lifestyle, you can take a vitamin D supplement. For adults, 10 micrograms a day of vitamin D is recommended.

The recommended amount for children is 7 micrograms for babies under six months, and 8.5 micrograms for children aged six months to three years. Talk to your GP for more information.

Read more about healthy eating and vitamins for children.

Other factors

Other lifestyle factors that can help prevent osteoporosis include:

Read more about healthy bones on the National Osteoporosis Society website.   

Content Supplied by NHS Choices

Brittle bones

Having osteoporosis doesn't mean you'll definitely have a fracture. There are measures you can take to reduce your risk of a fall or break.

Getting support

Your GP or nurse may be able to answer any questions you have about living with osteoporosis and can reassure you if you're worried.

You may also find it helpful to talk to a trained counsellor or psychologist, or to someone at a specialist helpline. Your GP surgery will have information about these.

Some people find it helpful to talk to others with osteoporosis, either at a local support group or in an internet chat room.

Osteoporosis support

The National Osteoporosis Society provide a helpline service run by nurses with specialist knowledge of osteoporosis and bone health.

Call 0845 450 0230 or 01767 472 721. You can also email them at nurses@nos.org.uk.

They can provide you with details of local support groups and also have an online discussion forum.

Recovering from a broken bone

Broken bones usually take six to eight weeks to recover. Having osteoporosis doesn't affect how long this takes. Recovery depends on the type of fracture you have. Some fractures heal easily, but others may require more intervention.

If you have a complicated wrist fracture or hip fracture, you may need an operation to make sure the bone is set properly. Hip replacements are often needed after hip fractures, and some people may lose mobility as a result of weakened bones.

Osteoporosis can cause a loss of height as a result of fractures in the spinal column. This means the spine is no longer able to support your body's weight and causes a hunched posture.

This can be painful when it occurs, but it may also lead to long-term (chronic) pain. Your GP or nurse may be able to help with this.

During the healing process, you may need the help of a physiotherapist or occupational therapist so you can make as full a recovery as possible.

Read more about physiotherapy and occupational therapy.

Coping with pain

Everyone experiences pain differently, so what works for you may differ from what works for someone else.

There are a number of different ways of managing pain, including:

You can use more than one of these techniques at the same time to manage your pain – for example, you could combine medication, a heat pack and relaxation techniques.

Working and money

You should be able to continue to work if you have osteoporosis. It's very important that you remain physically active and have a fulfilled lifestyle.

This will help keep your bones healthy and stop you focusing too much on your potential health problems. However, if your work involves the risk of falling or breaking a bone, seek advice from your employer, GP and the National Osteoporosis Society about how to limit your risk of having an accident or injury that could lead to a bone break.

If you can't continue working, you may be eligible for disability benefits, such as the Personal Independence Payment (PIP). People over 65 who are severely disabled may qualify for a disability benefit called Attendance Allowance.

Help for carers

You may also be entitled to certain benefits if you care for someone with osteoporosis.

Read more about benefits for carers.

More information

Content Supplied by NHS Choices

Brittle bones

Bob Rees was diagnosed with osteoporosis after collapsing in pain on a family holiday.

Bob Rees was diagnosed with osteoporosis after collapsing in pain on a family holiday.

"I was 43 when I was diagnosed with osteoporosis. I was on a family holiday in the Dominican Republic in June 2002 when I collapsed in agony. In March 2003, nine months later and after extensive tests, I was diagnosed with severe spinal osteoporosis.

"I remember my relief at being told that I didn't have bone cancer, as had been suspected, but my relief was shortlived when I was told that I had the bones of an 80-year-old.

"I turned to the National Osteoporosis Society (NOS) for support and I'm now an ambassador for the charity. I find that talking to other people with osteoporosis helps me deal with my own pain, and I advise anyone who has recently been diagnosed with osteoporosis to try to keep active. Don't sit back and give in. Small lifestyle changes, such as walking regularly, can help keep your bones healthy."

Share this page