Osteoporosis develops when your bones lose minerals faster than your body replaces them, so that your bones become fragile and brittle. The more fragile your bones are, the more likely they are to fracture or break when pressure is placed on them. While most people might end up with a muscle strain or bruise, people with osteoporosis can end up with a broken rib just from a cough or sneeze, or experience a hip fracture after tripping over an uneven surface or slipping on a wet bathroom/shower floor. 

Osteoporosis can significantly affect day-to-day activities. Just over one-third of people with osteoporosis experience some limitations to their daily activities and 15% experience severe restrictions in their daily life. 

This might mean being unable to continue a favourite activity, like dancing or riding a bike, or perhaps having to use a walker or wheelchair because of instability or pain.

Effective medicines are available to treat osteoporosis and help avoid fractures. Improving your diet and lifestyle and reducing your risk of falls can also help.

Complications of osteoporosis

The most common osteoporotic fractures happen in the hips, spine and wrists. These types of fractures can cause long-term pain, disability and loss of independence.

Osteoporotic fractures that occur in the spine can also lead to changes in your posture (eg, stooped back) and loss of height.

Those at higher risk of osteoporosis include postmenopausal women and older people.

Postmenopausal women are at particular risk because after menopause their bodies produce less of the female sex hormone, oestrogen, which plays an important role in maintaining bone strength.

Many other factors, including your lifestyle, diet, family history and having certain medical conditions, can affect your bones and increase osteoporosis risk, as can the long-term use of some medicines (eg, corticosteroids).

Talk to a health professional about assessing your bone health and risk of fracture.

A diagnosis of osteoporosis needs to be confirmed by a doctor. If you are at high risk of osteoporosis, or your doctor thinks you already have it, they may suggest a test called a dual energy X-ray absorptiometry (DXA/DEXA) scan to measure your bone mineral density (BMD). This test is quick and painless, like an X-ray.

The scan produces a result called a T-score which shows how different your BMD is from the BMD of an average young adult. 

• If you have osteoporosis, your T-score will be –2.5 or lower. The lower your T-score, the more brittle your bones are, and the greater your risk of fracture.
• If your bones are weaker than normal, but your T-score is not low enough for an osteoporosis diagnosis, then the doctor may tell you that you have osteopenia (this means the protein and mineral content of your bone tissue is reduced, but less severely than in osteoporosis).

A diagnosis of osteopenia is an early warning sign that you should be taking action to reduce your risk of osteoporosis.

• taking osteoporosis medicines as prescribed
• telling your doctor as soon as possible if you have stopped taking your osteoporosis medicine
• making sure you are getting enough calcium from your diet 
• ensuring you are getting enough vitamin D from your diet and from a few minutes of sunshine every day
• making lifestyle changes
• reducing your risk of falls by improving your balance and removing trip hazards from your home.

Speak with your doctor about the treatment options most suitable for your situation.

Find out more about managing osteoporosis

References 

• Australian Institute of Health and Welfare 2020. Osteoporosis. Cat. no. PHE 233. Canberra: AIHW (accessed 21 December 2021).
  
• Bliuc D, Nguyen ND, Nguyen, TV. et al. Compound risk of high mortality following osteoporotic fracture and refracture in elderly women and men. J Bone Miner Res 2013;2317-24.
• Australian Institute of Health and Welfare. Estimating the prevalence of osteoporosis in Australia. Canberra: AIHW, 2014 (accessed 10 June 2020).
• Naik-Panvelkar P, Norman S, Elgebaly Z, et al. Osteoporosis management in Australian general practice: an analysis of current osteoporosis treatment patterns and gaps in practice. BMC Fam Pract 2020;21:32. https://www.ncbi.nlm.nih.gov/pubmed/32050909

The following links have further information on the diagnosis, prevention and treatment for osteoporosis

• NPS MedicineWise Bone health action plan
• NPS MedicineWise Managing osteoporosis
• NPS MedicineWise: Osteoporosis: Data insights help build better bones
  
• Download factsheets from Healthy Bones Australia
• Read the Better Health Channel webpages on osteoporosis
• Read Osteoporosis: the latest on prevention and treatment, from the Choice website