Bone health and osteoporosis

What usually happens

A break from a minor fall after fifty is the diagnosis, not bad luck. Breaking a wrist tripping on a kerb is the single strongest sign that the next fracture is coming — and the point at which it can still be prevented. It is worth mentioning even years later.

There are no symptoms before that. Nothing aches, nothing warns you, which is why it is found by a risk assessment or a bone-density scan rather than by how you feel.

Sudden back pain with loss of height can be a spine fracture, and can happen without a fall. Worth an appointment rather than waiting for it to settle.

Preventing falls matters as much as treating bone. Strength and balance work, a review of medicines that cause dizziness, and eyesight and home hazards all count — bone strength only matters at the moment of a fall.

At your appointment

We will go through fracture history — yours and your parents' — along with steroid use, smoking, alcohol, early menopause and conditions that thin bone.

We will usually calculate your fracture risk over the next ten years, and may arrange a bone-density scan. The scan is painless and quick.

We will cover calcium, vitamin D and weight-bearing exercise, and be honest that on their own they are prevention rather than treatment once bone is already fragile.

If treatment is recommended we will explain what it does to your risk in plain numbers, and agree when to review.

Worth asking

• —What is my actual fracture risk, and what would treatment change about it?
• —Does the break I had a few years ago count?
• —What exercise is safe and useful for me specifically?
• —How long would I be on treatment, and what are the trade-offs?