Treatment and prevention of osteoporosis explained

What is osteoporosis and how common is it?

Osteoporosis is a progressive weakening of the bones and development of fractures. Some osteoporosis fractures may be silent, so anyone you know who may have lost height or have had intermittent back pain may well have osteoporosis. Osteoporosis affecting the hip is unfortunately very consequential - about 1100 patients die every month following a hip fracture in the UK - which translates to about 10% of osteoporosis patients. Another 10% don't survive the next 11 months, a quarter will go into an institution, and 80% who survive are not independent again. Yet we could have identified those patients who go on to have a hip fracture decades earlier and with simple interventions, could have prevented the progression to the fracture and all its consequences. Multidisciplinary approach to osteoporosis can result in improved bone health and reduction of future fractures.

How can osteoporosis be treated?

Osteoporosis fortunately can be treated in a number of different ways, including lifestyle changes - which are the foundation of all treatments - and pharmaceutical interventions. Regarding lifestyle, nutrition, particularly vitamin D and optimising calcium and other nutritional factors is important. Exercise has a critical role to play too, as muscle strength is very directly coupled with bone strength, and by improving muscle tone and muscle strength we are able to improve bone density and bone strength, and prevent fractures. There are a number of pharmaceutical agents which can be helpful - with these different interventions, we are able to reverse osteoporosis and reduce the risk of future fractures.

Is osteoporosis inevitable? Can it be prevented?

Osteoporosis can be prevented - our bones change throughout our life, reach their maximum level of strength around the age of 35, and then we might lose bone gradually over time. Precipitously, around the menopause about 5% of bone can be lost per year over a four of five year period. Interestingly, we also lose bone during any periods of inactivity and during pregnancy. 5% of bone is lost with each pregnancy.

There are a number of factors that increase bone strength or reduce bone strength throughout our life. Nutrition is a key factor in increasing strength, particulary the intake of vitamin D and calcium, but also exercise and muscle strength.

Things that affect bone loss are periods of inactivity, because as we lose muscle strength we lose bone. Other factors include drinking excess alcohol, which has a negative effect on the bone and smoking can reduce bone strength and produce bone loss, which increases likelihood of a future fracture. Certain medical conditions can also have a negative impact on bone health be that thyroid, diabetes, inflammatory bowel disease, inflammatory joint conditions or even treatments, such as steroids.

If you do have any of those conditions it is important that they are treated appropriately to reduce the negative consequences on your bone health.