Osteoporosis

Osteoporosis is a condition in which bones become weak and brittle due to loss of bone density, increasing the risk of fractures, particularly of the hip, spine, and wrist. It is often called a “silent” disease because bone loss occurs gradually without symptoms until a fracture happens.

• Usually no symptoms in early stages
• Loss of height over time or a stooped posture can be a sign of spinal compression fractures
• Back pain from a spinal fracture, which can occur with minimal or no obvious trauma
• A fracture from a relatively minor fall or bump, particularly of the hip, spine, or wrist, is often the first sign of osteoporosis

• Bone density naturally decreases with age, and osteoporosis develops when bone loss outpaces the body's ability to rebuild bone.
• Risk is increased by older age, being female (particularly after menopause, due to reduced oestrogen), low body weight, family history of osteoporosis or fracture, inadequate calcium or vitamin D intake, physical inactivity, smoking, excessive alcohol use, and long-term use of certain medicines such as corticosteroids.

• Often first suspected after a fracture from relatively minor trauma.
• Bone density testing (such as a DEXA scan), where available, is the standard way to measure bone strength and confirm the diagnosis, and can identify at-risk individuals before a fracture occurs.
• Risk assessment tools that combine clinical risk factors can help estimate fracture risk, particularly where bone density testing is not readily accessible.

Adequate calcium and vitamin D intake, through diet or supplementation as advised, supports bone health and is recommended for people with or at risk of osteoporosis.

Weight-bearing and muscle-strengthening exercise helps maintain bone density and improves balance, reducing fall risk.

For people with confirmed osteoporosis or a high fracture risk, a bone-strengthening medicine (such as a bisphosphonate) may be prescribed to reduce the risk of future fractures.

Fall-prevention measures — such as addressing home hazards, reviewing medicines that cause dizziness, and correcting vision problems — are an important part of reducing fracture risk.

Fractures are managed according to their location and severity, sometimes requiring surgery, particularly for hip fractures.

• Ensure adequate calcium and vitamin D intake through diet and, where advised, safe sun exposure or supplementation.
• Engage in regular weight-bearing exercise, such as walking, and muscle-strengthening activities.
• Avoid smoking and limit alcohol intake.
• Address fall risks at home, such as loose rugs or poor lighting, particularly for older adults.
• Discuss bone density screening with a health worker if at higher risk, such as after menopause or with a family history of fractures.