Over 1 million Australians have osteoporosis, with 2 in 3 people over the age of 50 with either osteoporosis or low bone density, putting them at increased risk of significant fractures. Australians clock up over 173,000 osteoporotic fractures a year, many of which cause significant pain, debility, hospitalisation and even death in some cases. And it’s not just a disease of post-menopausal women – around 25% of cases are in men.

The good news is that poor bone health and osteoporosis are largely preventable conditions that can also be treated effectively, reducing the risk of fractures. The key is to be aware of your risk factors, what you can do about them, how to tell if you already have osteoporosis and knowing what your treatment options are.

What is osteoporosis?
Literally meaning “bones with holes”, osteoporosis occurs when the breakdown of bone tissue overtakes the bone rebuilding process. This leaches calcium and strength from the bones causing them to weaken with an increased risk of fracture after minimal or even no trauma. Osteoporosis itself – without fractures – doesn’t cause symptoms, so is sometimes called the “silent disease”.

Who is at risk?
Osteoporosis can happen to anyone over about the age of 50 but can be seen in younger people. Some of the things which increase the risk are:

  • Family history of osteoporosis
  • Poor diet, especially if it’s low in calcium
  • Vitamin D deficiency, usually due to lack of adequate sun exposure
  • Low levels of physical activity, especially weight-bearing or resistance exercise
  • Smoking
  • Drinking alcohol
  • Low hormone levels such as early menopause in women or low testosterone in men
  • Being very thin or obese
  • Some medical conditions such as diabetes, coeliac disease, an overactive thyroid, conditions requiring treatment with cortisone and others.

How to diagnose osteoporosis
Based on your age, family history and other risk factors your doctor may recommend a bone density test, or DXA scan. This is a targeted, non-invasive Xray test looking at specific risk areas, such as the hips and spine, giving an accurate measure of bone density and fracture risk. It can also be used to check on the progress of bone loss or the effect of treatment.

Treatment Options
If you are diagnosed with osteoporosis there are a number of treatment options available, ranging from specific exercise programs to medications. The goal of treatment is to prevent a fracture, or, if one has already occurred, to prevent further fractures.

Many of the osteoporosis treatments work to strengthen the bones by preventing further bone loss and are very effective and well tolerated. They range from medications specifically acting on bone metabolism through to hormone-based or hormone-like therapies. They may come in tablet form, 6 monthly injections, a once a year infusion or even cream, gel or patch therapies.

Your doctor may also recommend specific exercise programs that have been proven to improve bone density and strengthen muscles to improve balance and reduce the risk of falls.

Most management plans will also include tailored lifestyle advice to improve your bone health.

How to improve your bone health

  • Regular weight-bearing exercise such as brisk walking for 30 minutes a day plus 2-3 sessions per week of strength and balance exercises such as resistance bands or yoga
  • Avoid smoking
  • Limit alcohol consumption
  • Eat a healthy, balanced diet with plenty of fresh fruit, veggies and whole grains. Include 3 serves of calcium rich foods per day e.g. dairy, small fish like sardines, seeds and nuts
  • Get out and (safely) enjoy the sunshine – exposing your face and arms for a few minutes a day in summer and around 20 minutes a day in winter (in Sydney) is all you need to get your daily vitamin D
  • There are some new sunscreens on the market that allow more of the vitamin D-producing UVB light in without sacrificing SPF
  • If your diet or sun exposure can’t be improved, then calcium or vitamin D supplements may be helpful (check with your doctor)
  • Keeping your weight in the healthy range

If you are concerned about your risk of osteoporosis or would like to know more about how best to support your bone health, please come and see us for a chat.

Photo by Joyce McCown on Unsplash

Further reading:

Healthy Bones Australia
healthybonesaustralia.org.au

Bone health online tool
Check your bone health

Osteoporosis in men
betterhealth.vic.gov.au

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