Osteoporosis is a condition in which the amount of bone is diminished and there is an increased likelihood of fractures. The most common fractures associated with osteoporosis are fractures of the hip, fractures near the wrist and fractures of the bones of the spine. Spine fractures may lead to a reduction in height.

Secondary Osteoporosis

Osteoporosis can be secondary to other conditions such as an overactive thyroid gland, overactive parathyroid glands, coeliac disease, rheumatoid arthritis and other conditions.

What are the symptoms of osteoporosis?

Osteoporosis itself does not cause any symptoms unless a fracture occurs. It is a common but incorrect fallacy that chronic aches and pains may be a feature. Even in a person known to have osteoporosis such symptoms usually have another cause; backache is more commonly due to wear and tear in the joints of the spine. One rare cause of pain is in a patient whose spine has become so shortened that the lower ribs touch the upper part of the pelvis.

Why do people get osteoporosis?

The most common cause of thinning of the bone is the natural loss of bone that occurs in women over the years after the menopause. However the likelihood of fracturing in later life depends in part on that loss but also in part on the amount of bone in the body at the time of the menopause. This depends on several factors including the amount of exercise taken over the years and the amount of calcium (mainly from dairy products) in the usual diet. Smoking and alcohol are damaging to the bones; smoking twenty cigarettes a day leads to a reduction of between five and ten percent in the amount of bone and approximately a doubling of the risk of fracture in later life.

Who is at special risk of osteoporosis?

The likelihood of bone thinning is increased in women who have an early menopause (before the age of 45) or who have had their ovaries removed for any reason. It may occur in people with intestinal disorders in which the absorption of foodstuffs is impaired. It is a particular problem in women and men who have disorders that need treatment with steroids such as prednisolone. It is thought that the risk is particularly great in people who need to take more than 7.5 milligrams prednisolone (or equivalent) each day long term. Short courses of steroids do little harm. Men who have lost their testes (the source of male hormones) are at special risk of osteoporosis.

Who should be concerned about osteoporosis?

Someone who has a fracture ‘too easily’, for example with a minor injury.
Someone who has a spontaneous fracture, for example in the spine.
A woman who has an early menopause.
Someone who has to take steroid therapy long term.
Someone with a lot of close relatives who had osteoporosis or unexplained fractures.
How is fracture risk assessed?

One important method is by bone density scans. A variety of methods can be used. However bone density is only one factor in fracture risk. Another is a history of previous fractures. A very important one is the risk for falls. Preventing falls can do as much or more to prevent fractures happening as any medical treatment for osteoporosis.

What can be done to prevent osteoporosis?

Take exercise regularly.
Have a diet with adequate amounts of calcium (from, for example, milk, cheese and yoghurt).
Ensure getting adequate amounts of vitamin D either from food, such as fatty fish and margarine, or from moderate exposure to sunlight.
Don’t smoke and don't drink excessive amounts of alcohol.
Seek a bone density check if you fit into one of the high-risk groups above.

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