Osteoporosis

There are no specific symptoms of bone loss. However, once the bones are affected by osteoporosis, you might notice signs such as:

• bones breaking more easily than expected – wrists, hips, and spine are the most common

• stooped posture

• back pain

• loss of height with age

Bones are living tissues and are constantly renewing themselves. When you’re a child or adolescent, you form new bone very quickly as you grow and develop. Bone density is at its highest in your mid to late 20s. After that, bone gets replaced at the same rate as it’s broken down – until around age 40. At this age, bone starts to be broken down more quickly than it’s replaced, causing a loss of bone density. Losing bone density faster than normal can lead to osteoporosis.

There are many factors that can increase your risk of developing osteoporosis. Some you can change, others you can’t. These include:

• being female – women usually have smaller bones, which are affected by menopause, especially if it happens early or due to medical treatment

• genes that determine the size and strength of your skeleton

• family history of osteoporosis

• certain medical conditions such as coeliac disease, inflammatory bowel disease, rheumatoid arthritis, overactive thyroid, eating disorders such as anorexia or bulimia, and cancer

• certain medications such as oral steroid tablets (if you take them for over 3 months), breast cancer and prostate cancer medications that affect hormones, and anti-epileptic medications

• lack of weight-bearing exercise

• poor diet, low in nutrients your body needs to build bone

• drinking too much alcohol – it affects how your body builds and breaks down bone

• smoking – it slows down the cells that build bone in your body

• having a low body mass index (BMI)

If you have risk factors for osteoporosis, your consultant might decide to check your bone density. Even if you have osteopenia, which means your bone density is lower than the normal range, but not low enough to be diagnosed as osteoporosis, getting a diagnosis means you can take action to strengthen your bones and potentially prevent osteoporosis.

Diagnosing osteoporosis or osteopenia usually involves an initial consultation where our heart health specialist will:  

1. Take a history to get a full understanding of your family history, health status and risk factors.

2. Review any relevant scans and other previous investigations.

3. Organise a DEXA (dual-energy x-ray absorptiometry) scan to measure the density of your bones and make a diagnosis.

Your bone density results are compared to a healthy range. Any difference is calculated as a standard deviation (SD).

• above -1 SD is normal

• between -1 and -2.5 SD shows bone loss and is defined as osteopenia

• below -2.5 shows bone loss and is defined as osteoporosis

You can help reduce your risk of bone loss and osteoporosis with some proven approaches to boost your bone density and strength:

• quit smoking if you smoke, because it stops your bones from rebuilding as well

• get active – weight-bearing and resistance exercise helps to strengthen bones

• talk to your consultant about hormonal health during peri/menopause, as some research suggests HRT can help keep your bones strong

• eat a healthy balanced diet rich in calcium and vitamin D, and take a daily supplement of 10 micrograms of vitamin D

• limit your alcohol intake to the maximum recommended 14 units per week

• manage your coffee (not tea) intake, as it can slightly increase the amount of calcium in your urine - if your calcium intake is low, you have osteopenia or other risk factors, have no more than 4 cups of coffee a day

• swap cola for carbonated water -  there’s evidence that people who drink a lot of cola may be at risk of bone loss, possibly due to phosphoric acid

• lower your salt intake – high salt diets can increase the amount of calcium you pass in your urine

• maintain a healthy weight

Osteoporosis doesn’t stop your bones from healing after a break, but for some people, it can mean spinal bones heal in a different, more compressed shape that leads to:

• height loss

• curvature of the spine or a change in posture

• ongoing back pain and muscle spasms

Once osteoporosis has been diagnosed, and your consultant is clear about the possible cause, they’ll recommend the most appropriate next steps and arrange treatment to ensure you make the best possible recovery. Treatment options include:

• medicine to slow the rate at which your body breaks down bone (bisphosphonates)

• medicines for women during or after peri/menopause, to give bones the same sorts of bone-strengthening effects as the hormone oestrogen has (selective oestrogen receptor modulators, and HRT)

• medicines to regulate the amount of calcium in bone and stimulate the creation of new bone (parathyroid hormone injections such as teriparatide)

• medicines called biologics that slow the rate of bones being broken down and speed the rate they build up (such as denosumab and romosozumab) – for people who can’t take other medicines or who have severe osteoporosis

• zoledronate infusion, which helps strengthen bones and reduce the risk of fractures

• calcium and vitamin D supplements

• medical treatment to help any fractures heal

Our consultants have access to multidisciplinary teams who can be brought in to support your personalised bone health management plan.

At Welbeck, our bone health specialists are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.

Get in touch today to book an appointment.