What is Osteoporosis?

Osteoporosis is a common disease where the bones become weakened. The ability of the body to make new bone cannot keep up with bone less. As a result, those with osteoporosis have poorer bone density and strength. According to the Royal Australian College of General Practitioners [1], around 66% of people over 50 have poor bone health. The Australian Bureau of Statistics [2] also showed that more than 900,000 Australians had osteoporosis. Those who are female and over the age of 45 are more likely to experience bone density problems.

Osteopenia vs Osteoporosis

Although similar, osteopenia and osteoporosis are different types of conditions. Osteopenia is less severe and can be seen as an earlier stage of osteoporosis. These conditions can be diagnosed through bone scans and compared to the expected bone density scores [3].

Osteoporosis Symptoms

Osteoporosis is considered a ‘silent disease.’ Most people with osteoporosis, many will not experience symptoms. As the condition becomes more advanced, it can lead to future complications, such as fractures. When this happens, some people may notice symptoms, such as changes in posture and pain in the presence of a fracture(s).

What Causes Osteoporosis?

Osteoporosis occurs when there is an imbalance with normal bone activity. The body will routinely break down old bone and replace it with new bone. This is to help maintain healthy and strong bones. When osteopenia or osteoporosis occurs, the ability of the body to produce new bone tissue cannot keep up with its breakdown. Over time, this can weaken the bones and increase the fracture risk and injury.

Osteoporosis Risk Factors

Risk factors are characteristics of an individual that can increase the risk of osteoporosis [4]. Non-modifiable risk factors are characteristics you cannot change, while modifiable risk factors can be changed.

Non-Modifiable Risk Factors

Female gender, especially after menopause
Age, especially after 45
Having a small and thin body frame
Certain ethnic backgrounds (e.g. Asian, white, etc.)
Having a family history of osteoporosis and/or bone fractures

Modifiable Risk Factors

Hormone imbalance
Being anorexic
Having low calcium and/or Vitamin D levels
Using certain medications
Being inactive
Cigarette smoking
Drinking too much alcohol

Tests and Diagnosis

Osteoporosis and/or osteopenia can be difficult to detect because there are no symptoms until a possible fracture. It’s essential to speak to your GP about your medical history to determine whether any tests are required. If you’ve had a recent fracture or are at risk of poor bone health, you may be required to perform any necessary assessments.

Dual Energy X-Ray Absorptiometry (DXA Scan)

A DXA Scan is the most reliable way to diagnose osteopenia and osteoporosis [5]. The scan uses x-ray technology to determine your body’s bone density, a measurement used to assess bone strength. A T-score or a Z-score will be calculated after comparing your results with the expected bone density of a young adult or around a similar age. Your GP will use these results to provide a diagnosis and reflect on your bones’ strength.

Osteoporosis Treatments

Currently, there is no cure for osteoporosis. However, some treatments can help improve bone strength and minimise the risk of falling to help prevent possible fractures. Treatment for osteoporosis will depend on your medical history, your DXA scan findings and your GP’s clinical judgement.

Lifestyle Changes

Changing old habits and/or lifestyle choices is crucial for strengthening your bones. Where appropriate, your GP may provide suggestions about what you can change during your daily life to improve your bone health. Referrals to other healthcare professionals can also be made for guidance. Examples of lifestyle changes may include [6]:

Strategies to reduce the risk of falls (e.g. rails in the shower, having well-lit rooms, etc.)
Changing your nutrition and diet
Regular physical activity
Quit smoking
Reduce alcohol consumption

Exercise for Osteoporosis

Individuals who are inactive and do not exercise are more likely to develop osteoporosis. Exercises such as weightlifting and supervised impact landing activities can help strengthen bones. Starting these exercises from a younger age can also help prevent osteoporosis. Balance exercises are also recommended to reduce the chance of falling and breaking a bone(s) [7]. Your GP may refer you to an exercise physiologist or physiotherapist to help develop a safe exercise plan.

Medication and Supplements

Your GP may prescribe medications to slow down and prevent bone loss. Vitamin D and/or calcium supplements are helpful building blocks for bone development. In some circumstances, osteoporosis can also lead to pain. If so, your GP may recommend pain relief medication too. Always take your medications under the guidance of your GP.

Referral to a Specialist

Under some situations, your doctor may refer you to a rheumatologist and/or orthopaedic specialist for further medical review. Additional tests and treatments may be ordered to help address ongoing issues.

Recovery

Currently, osteoporosis is not curable. However, with the proper medical treatment and lifestyle changes, you can improve bone strength and reduce the chances of future fractures. Starting appropriate lifestyle strategies (e.g. exercise, stop smoking, etc.) at an early age can help reduce bone loss and weakness.

Complications

The most common complication of osteoporosis are fractures, particularly around the hip and back regions. According to Osteoporosis Australia, more than 180,000 people are likely to have a fracture that has been contributed by osteoporosis [8]. Hip fractures often occur from falling and can lead to long-term disability. Some people may require hip surgery, which can require extensive recovery and rehabilitation. Additionally, fractures along the spine can lead to changes in posture, disability and back pain. The bone becomes so weak that fractures can occur without trauma for some people.

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