Preventing Osteoporosis and Fragility Fractures: How to Keep Your Bones Strong
Many people think that weak bones are simply a normal part of getting older. They are not.
As we age, our bones can gradually lose their strength and density. This can lead to osteoporosis, a condition in which bones become fragile and are more likely to break.
The worrying part is that osteoporosis can develop silently. You may have no pain or warning signs until you suffer a fracture.
The good news is that bone loss can often be slowed, and your risk of fractures can be reduced through the right lifestyle, nutrition, screening and treatment.
What Is Osteoporosis?
Osteoporosis means that the bones have become less dense and weaker than normal.
Healthy bone is not a solid, lifeless structure. It is living tissue that is continuously broken down and rebuilt.
When bone loss becomes greater than bone formation over time, bones gradually become weaker.
The result is an increased risk of fractures, particularly involving the:
Osteoporosis is sometimes called a “silent disease” because bone loss may occur without symptoms.
What Is a Fragility Fracture?
A fragility fracture is a fracture that occurs after a minor injury or fall that would not normally break a healthy bone.
For example, a fracture occurring after:
can sometimes be a sign that the underlying bone is weak.
A previous fragility fracture is an important warning that the person may be at increased risk of having another fracture.
Who Is at Risk of Osteoporosis?
Osteoporosis can affect both men and women, although the risk increases significantly with age.
Risk factors include:
Increasing age
Bone density generally decreases as we get older.
Menopause
The decline in estrogen after menopause can accelerate bone loss in women.
Family history
Having a parent who suffered a hip fracture may increase your risk.
Low body weight
Being underweight can be associated with lower bone mass and increased fracture risk.
Lack of physical activity
Bones and muscles benefit from regular physical activity. A sedentary lifestyle can contribute to loss of bone and muscle strength.
Smoking
Smoking is associated with poorer bone health and increased fracture risk.
Excessive alcohol consumption
Heavy alcohol consumption can negatively affect bone health and increase the risk of falls.
Certain medications
Long-term use of some medicines, particularly corticosteroids, can significantly increase the risk of osteoporosis.
Certain medical conditions
Some endocrine, gastrointestinal, kidney and other chronic diseases can affect bone health.
How Can You Prevent Osteoporosis?
Prevention should ideally begin before significant bone loss occurs.
1. Get Enough Calcium
Calcium is an essential building block of bone.
Good dietary sources include:
-
Milk
-
Curd and yoghurt
-
Cheese
-
Ragi
-
Sesame seeds
-
Soy products
-
Green leafy vegetables
-
Some nuts and seeds
-
Calcium-fortified foods
It is generally better to obtain calcium through a balanced diet rather than automatically taking supplements.
If your dietary intake is inadequate, your doctor can advise whether supplementation is appropriate.
2. Maintain Adequate Vitamin D
Vitamin D helps the body absorb calcium and plays an important role in bone and muscle health.
Vitamin D can be obtained through:
-
Sensible sunlight exposure
-
Foods containing vitamin D
-
Supplements when medically indicated
Vitamin D deficiency is common in many populations, including in people who spend little time outdoors.
If you are at risk of deficiency, your doctor may recommend a blood test.
Do not take very high doses of vitamin D on your own. More is not necessarily better.
3. Exercise Your Bones and Muscles
One of the most effective ways to maintain bone and muscle strength is regular physical activity.
Useful activities include:
Weight-bearing exercise
Examples include:
-
Brisk walking
-
Stair climbing
-
Dancing
-
Hiking
Strength training
Resistance exercises help strengthen muscles and can also support bone health.
Balance exercises
Activities that improve balance can reduce the risk of falls.
For older adults, preventing the fall is just as important as strengthening the bone.
If you already have severe osteoporosis or a previous fracture, speak with your doctor or physiotherapist before starting a new exercise programme.
4. Avoid Smoking
Smoking can negatively affect bone health and is associated with increased fracture risk.
If you smoke, stopping is one of the important steps you can take for your overall health—including your bones.
5. Limit Excessive Alcohol
Heavy alcohol consumption can affect bone health and also increase the risk of falling.
Keeping alcohol consumption low or avoiding it altogether is beneficial for overall health.
6. Maintain a Healthy Body Weight
Being significantly underweight can increase the risk of low bone density and fractures.
The goal is not simply to weigh less.
The goal is to maintain healthy body composition, adequate nutrition, muscle strength and bone health.
7. Prevent Falls at Home
For older adults, a strong bone can still fracture if a person falls.
Simple changes can make the home safer:
-
Remove loose carpets and clutter
-
Keep floors dry
-
Improve lighting, especially at night
-
Install handrails where needed
-
Use appropriate footwear
-
Be careful on stairs
-
Consider grab bars in bathrooms
-
Review medicines that may cause dizziness or drowsiness with your doctor
-
Have vision checked regularly
Fall prevention is an important part of fracture prevention.
Should You Have a Bone Density Test?
A bone mineral density (BMD) test, usually performed using a DXA scan, can help assess bone density and fracture risk.
Screening is particularly important for people who have increased risk because of factors such as:
-
Older age
-
Postmenopausal status
-
Previous fragility fracture
-
Long-term steroid treatment
-
Family history of osteoporosis or hip fracture
-
Low body weight
-
Certain medical conditions or medications
Your doctor can determine whether and when a bone density test is appropriate for you.
What If Osteoporosis Has Already Developed?
Having osteoporosis does not mean that nothing can be done.
Depending on your fracture risk, your doctor may recommend:
-
Lifestyle modification
-
Calcium and vitamin D optimisation
-
Exercise and fall prevention
-
Prescription medications that slow bone loss
-
Medications that help build bone in selected high-risk patients
-
Treatment of underlying medical conditions contributing to bone loss
The choice of treatment depends on your individual fracture risk, age, medical history, kidney function, previous fractures and other factors.
Do not start osteoporosis medication or high-dose calcium/vitamin D supplements without medical advice.
Why Hip Fractures Are Particularly Serious
A hip fracture in an older person can have consequences far beyond the broken bone.
It can lead to:
This is why preventing a hip fracture is much more important than simply treating the fracture after it happens.
Strong bones + strong muscles + good balance = lower fracture risk.
Can Osteoporosis Be Reversed?
Bone health can often be improved or stabilised, depending on the individual's condition and treatment.
However, it is better to think about osteoporosis as a condition that requires long-term management, rather than looking for a quick cure.
The earlier significant bone loss is identified, the more opportunities there are to reduce future fracture risk.
Don't Wait for Your First Fracture
One of the biggest mistakes is waiting until a fracture occurs before thinking about bone health.
If you are older, postmenopausal, have a family history of hip fracture, have taken long-term steroids, or have already suffered a fracture after a minor fall, it may be worth discussing your bone health with your doctor.
A fracture should not simply be dismissed as “an accident because of age.”
Sometimes, the fall is only the event that reveals an underlying problem with bone strength.
7 Simple Steps for Stronger Bones
Remember these seven points:
1. Eat a balanced, calcium-rich diet.
2. Maintain adequate vitamin D.
3. Exercise regularly, including strength and weight-bearing activities.
4. Don't smoke.
5. Avoid excessive alcohol.
6. Prevent falls, especially at home.
7. Check your bone health when you are at increased risk.
Osteoporosis may be silent, but its consequences can be serious.
You do not have to wait until you break a bone to start taking care of your bones.
A healthy diet, adequate vitamin D, regular weight-bearing and resistance exercise, avoidance of smoking, sensible alcohol consumption, fall prevention and appropriate screening can all contribute to better bone health.
And if you have already had a fracture after a minor fall, don't just treat the fracture—ask why the bone broke so easily.
The fracture may be the first warning sign that your bones need attention.
At SIDS Hospital & Research Centre, our multidisciplinary team provides comprehensive evaluation and treatment for a wide range of medical and surgical conditions. Patients with osteoporosis, recurrent falls or fragility fractures may benefit from assessment of their underlying risk factors and appropriate specialist care.
If you are concerned about your bone health or have suffered a fracture after a minor injury, speak with your doctor about whether osteoporosis evaluation is appropriate for you.