Osteoporosis is a condition which causes weakened fragile bones which increases the risk of fracture. Robert Mair investigates.

In this article:

  • What is osteoporosis?
  • The risks
  • Treatment

What is osteoporosis?

Osteoporosis is a disease of the bone and has been linked to a direct increase in the risk of fractures. The disease reduces the bone mineral density, meaning its structure is weakened. Bone is made up of a hard outer shell and an inner honeycomb-like structure. In Osteoporosis, the inner honeycombing thins out and the density – and thus the strength – of the bone is compromised.

The disease occurs over years and is part of the normal ageing process. Two cells work in the bones to regulate strength. Up until about the age of 25, the cells responsible for increasing the strength of the bones work and these get superseded by cells that reduce strength from the age of 40.

The risks

Despite the best preventative measures, some people will still be more at risk than others. Those particularly in danger include:

  • Women who’ve had an early menopause or hysterectomy with the removal of both ovaries before the age of 45
  • Men with low levels of testosterone
  • People with diseases of the hormone producing glands such as hyperthyroidism
  • Long-term use of medications which affect bone strength or hormones such as ‘oral-prenisolone’
  • Heavy drinkers and smokers
  • Those with a family history of the disease
  • People who are underweight or who have an eating disorder
  • Those who have difficulty absorbing nutrients from food
  • Those affected by digestive conditions such as Crohn’s disease
  • People with a medical condition that leaves them immobile
  • People who use corticosteroid tablets for conditions such as asthma or arthritis
  • People who have broken bones after a minor fall

Osteoporosis is difficult to identify because there are few visible symptoms. Often, it is only diagnosed after a fall results in a fracture – but there are a couple of signs to watch for. Height loss can indicate a reduction in bone density, as can curvature of the spine (kyphosis). This can make people appear ‘hump-backed’.

A special scan is available to diagnose osteoporosis. The Duel Energy X-ray Absorptiometry (DEXA) scan measures bone density using low levels of radiation and is a simple, pain-free procedure. But it is only available for people at a high-risk of breaking a bone.


Although osteoporosis is not painful in itself, fractures are – and a number of treatments are available once the disease has been diagnosed. Older people are also likely to be prescribed calcium and vitamin D.

The first line of drugs usually used is bisphosphonates; women may also be offered hormone replacement therapy, and men testosterone therapy. Your GP will advise which course of medicinal action (if any) is best for you.

Other factors that help include reviewing your diet to make sure it is balanced and contains different vitamins and minerals. Calcium is very important, as is fish, meat, fruit and vegetables, and dairy products. Exercise can also help build up the strength of bones, and not smoking is also advised; cigarette smoke has a toxic effect on the bone structure. Drinking in moderation is also beneficial – especially a glass of red wine.

If you are diagnosed with osteoporosis, your GP or a nurse should be able to answer any questions you have on how to reduce your chances of fall and resultant fracture.

You may also find it beneficial to talk to others with the condition.