Osteoporosis: The Silent Bone Loss Behind Hip Fractures
A hip fracture after sixty carries a mortality comparable to some cancers. The bone loss that causes it is painless, detectable and treatable years in advance.
Read articleOsteoporosis is thinning of the bone that makes it fragile enough to break after a minor fall or even a cough. It is silent until the first fracture, and it is particularly common in women after menopause and in older adults with poor sun exposure and low calcium intake.
Symptoms
Not everyone gets every symptom, and the pattern can differ in older people, in people with diabetes and in children. These are the ones most often reported.
- No symptoms at all in the early stage
- A fracture after a trivial fall or a minor twist
- Loss of height over the years
- Increasing stoop of the upper back
- Sudden severe back pain from a spinal compression fracture
When to see a doctor
Do not wait these out
If any of the following applies, arrange to be seen the same day. For anything sudden or severe, call 9281862028 or come straight to the emergency department at SIMS — it is open 24 hours and does not need an appointment.
- Any fracture from a fall from standing height in an adult over 50
- Sudden severe back pain in an older adult, particularly a woman after menopause
- Noticeable loss of height or increasing stoop
- Before starting or while on long-term steroid treatment
Tests that may be advised
Your consultant will order only the investigations that change the plan. Most of the following are available on the SIMS campus, so results usually come back the same visit.
- Bone mineral density scan (DEXA)
- Serum calcium, phosphate and alkaline phosphatase
- Vitamin D level
- Thyroid and parathyroid assessment
- X-ray of the spine where compression fracture is suspected
How it is treated
Treatment is decided case by case — by how advanced the problem is, what else you are being treated for, and what you can realistically sustain. Broadly, it involves the following.
- Adequate dietary calcium and correction of vitamin D deficiency
- Safe daily sun exposure and weight-bearing exercise such as walking
- Specific bone-strengthening medication where the density scan and risk profile justify it
- Fall prevention at home — lighting, footwear, bathroom grab bars, removing loose mats
- Stopping tobacco and limiting alcohol, both of which accelerate bone loss
This page is general information, not a diagnosis
Osteoporosis can look like several other conditions, and the reverse is equally true. Nothing here can replace an examination, your test results and the judgement of the doctor treating you — and no medicine mentioned by name to a friend or relative should be started on the strength of this page. If you recognise yourself in it, book a consultation with the Orthopaedics department. If a symptom is sudden or severe, call 9281862028.