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Understanding your bone health -Osteoporosis

Did you know that throughout life, our bones are being constantly re-modelled with old bone cells being removed and replaced by new bone cells? As we get older, the balance starts to alter and we lose more bone than we gain.

Osteoporosis means ‘porous bone’ and describes bone that has become so weak that fractures (broken bones) become a real risk. This type of fracture (fragility fractures or osteoporotic fractures) often happens in the wrist, hip or spine usually as a result of a fall. Osteoporotic fractures in your spine (vertebrae) can occur without a fall simply from the weight of being squashed or compressed when you are upright. This type of fracture can lead to height loss and a curved spine (kyphosis). Spinal fragility or compression fractures tend to be stable and don’t cause nerve damage or paralysis. In some cases, people don’t even know they have a spinal fracture and it is picked up during routine examination. In other cases, they can be a cause of long-term pain and disability.

Understand your risk factors

It’s important to understand what your risk factors for developing osteoporosis are. Once you know these, there are many steps that you can take to reduce the risk of breaking a bone.

•    Age. From around the age of 45 we start to lose more bone than we make new bone and for women, menopause accelerates this process. Currently, half of people over 75 have osteoporosis.
•    Family history. Find out if either of your parents ever broke their hip.
•    Low oestrogen in women. This can be as a result of menopause (when periods stop) and especially early menopause (before the age of 45) or other medical conditions including anorexia nervosa.
•    Low testosterone in men. Perhaps as a result of surgery or certain cancers 
•    Hyperthyroidism
•    Parathyroid disease
•    Conditions that affect how well you absorb food such as Chrohn’s Disease. 
•    Conditions that cause reduced mobility or a sedentary lifestyle.
•    Rheumatoid arthritis 
•    History of previous fragility fractures
•    Falls
•    Some medicines. For example, steroid tablets in strong doses for more than 3 months, and some cancer drugs. **It is important to discuss with your Dr any changes to your medications – don’t stop medicines without medical advice and supervision.**

What can you do?

Contact your GP surgery. If you think you may be at risk of osteoporosis ask for a bone health consultation. Your GP or specialist nurses can help you decide what interventions are necessary, such as hormone replacement therapy, calcium supplementation or vitamin D and if you need to have further investigations such as a DEXA scan ( a scan to measure your bone density).

Eat a well-balanced diet. Include sources of calcium (dairy foods, leafy green vegetables, bread and soya products that have been fortified with calcium) and vitamin D (oily fish, red meat, egg yolks, liver, fortified foods such as breakfast cereal). Consider taking a vitamin D supplement in the dark winter months 

Get outside. If you can, spend half an hour each day outdoors with your head uncovered to maximise the vitamin D we get from the sun.

Keep active. When our muscles pull on our bones to make our arms, legs and body move, it stimulates the creation of new bone. Weight-bearing exercise and strength training are important. See a physiotherapist or exercise professional for advice. If you already have osteoporosis, the Royal Osteoporosis Society recommends that you keep moving and exercising, even if you have broken a bone in the past.
Work on your balance. Reduce the risk of future falls. See a physiotherapist or exercise professional for advice.

Stop smoking and avoid excessive alcohol consumption.

Keep to a healthy body weight

The Royal Osteoporosis Society website ( has lots of information to help you further – check out their resources or contact a physiotherapist or exercise professional. 

About the author

Lesley Hodgson - BSc - MCSP - HCPC

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