Guarding Your Bones: A Comprehensive Guide to Osteoporosis

Dr. James - Orthopaedic Surgeon in Singapore

Medically reviewed by Dr. James Tan

Osteoporosis is a hidden bone disease, often unnoticed until osteoporosis fractures strike. While it’s not easy to detect, understanding the causes, symptoms, risk factors, and the importance of early detection will equip you to protect your bone health and quality of life.

Whether you have been diagnosed with osteoporosis and are seeking solutions or you just want to learn about your potential risk factors, you’ve found the right resource. This is your complete guide to osteoporosis.

What is Osteoporosis?

In simple terms, osteoporosis is a bone disease that causes a loss in bone density and strength. This loss of density and strength increases your risk of bone fractures. Your hips, spine, and wrists are at a particularly high risk for breakage.

Helpful Tip: People often confuse the difference between bone fractures and broken bones. For clarity, a fractured bone is exactly the same as a broken bone.

Marked by low bone mass and bone tissue deterioration, osteoporosis is a disease that causes weak and brittle bones that are prone to fracture. People often refer to this condition as a “silent disease” because it is incredibly common to experience bone loss without actually having any symptoms.

While osteoporosis is more common in women, men can also develop it as well. In general, all of us, particularly as we age, are at risk for osteoporosis.

What Are the Symptoms of Osteoporosis?

Osteoporosis does not have obvious symptoms until you break a bone. While it can be incredibly hard to detect, there are osteoporosis symptoms that you can look out for, such as the following:

  • Loss of height over time
  • Stooped posture or curved upper back
  • Fractures from minor bumps or falls
  • Sudden, severe back pain (may indicate a vertebral compression fracture)

Since a fracture is often the first sign, it is important to understand risk factors and get a bone density test to check for low bone mass. Catching osteoporosis early allows treatment to prevent future fractures.

What Causes Osteoporosis?

In simple terms, osteoporosis happens when there is an imbalance between the formation of new bones and the breakdown of old bones. As we age, it is common for our bones to break down and be absorbed faster than new bones are formed. But, why exactly does this happen? What causes this breakdown and lack of bone replenishment?

There are a few key factors that can lead to osteoporosis:

  • Being over 35 years old
  • Menopause
  • Low testosterone (only an issue for men)
  • Family history of osteoporosis
  • Calcium deficiency
  • Vitamin D deficiency
  • Sedentary lifestyle
  • Loss/lack of muscle mass

There isn’t just one thing that causes osteoporosis. Your age, hormones, genetics, nutrition, and lifestyle all impact your bone health. Recognizing the different contributors and your personal risks is crucial for prevention.

Risk Factors for Osteoporosis

Anyone can get osteoporosis but these are some factors that’ll make it more common for you.

  • Being female
  • Being older in age
  • Having a family history of osteoporosis
  • Having a small, thin body frame
  • Being post-menopausal for women
  • Having low testosterone as a man
  • Not getting enough calcium and vitamin D
  • Living an inactive lifestyle
  • Smoking and drinking excessively
  • Taking certain medications like steroids or seizure meds

These risks do not guarantee osteoporosis but indicate an elevated chance. If any apply to you, focus on prevention strategies and lifestyle changes to maintain bone health.

Who Gets Osteoporosis?

While both genders can develop osteoporosis, older women have the highest risk. In fact, 1 in 2 women over 50 will have an osteoporosis-related fracture, while only 1 in 4 men over 50 will break a bone due to osteoporosis.

But why is osteoporosis so common for women? One factor is that menopause causes women’s oestrogen levels to drop quickly, which speeds up bone loss. This is an issue of particular concern for older Caucasian and Asian women who have the highest risk factor. Women with a small, thin body frame have increased risk as well.

When Should I See My Doctor About Osteoporosis?

It is always a good idea to discuss your osteoporosis risk with your doctor early to maximise bone health. Here are some signs you should have that conversation now:

  • Women over 65 and men over 70 should get a bone density test
  • Anyone with fractures from minor injuries should be evaluated
  • After losing 1.5 inches of height
  • Having new back pain
  • Family history of osteoporosis
  • Medication use that increases your risk
  • Experiencing the transition into menopause

Don’t wait for a fracture to see your doctor. Being proactive allows early interventions to improve bone density and prevent osteoporosis progression.

How is Osteoporosis Diagnosed?

To diagnose osteoporosis, your doctor is going to assess your risk factors, give you a bone density test, and rule out other causes of any possible symptoms. Here are some common tests that your doctor may order:

  • Dual-energy x-ray absorptiometry (DEXA) to measure bone mineral density
    • The T-score from DEXA indicates normal, low bone mass, or osteoporosis.
  • Physical exam looks for height loss, fractures, or stooped posture
  • Medical history identifies risk factors or secondary causes
  • Blood tests check for conditions affecting bone health

A DEXA scan is the gold standard for diagnosis. Combined with clinical information, it allows proper categorization and treatment decisions.

How Is Osteoporosis Treated?

Osteoporosis treatment is all about reducing bone resorption, improving bone density, and preventing fractures. Here are some treatments that your doctor may recommend:

  • Bisphosphonates like alendronate reduce bone breakdown
  • RANK ligand inhibitors like denosumab decrease resorption
  • Oestrogen therapy replenishes oestrogen to maintain bone in women
  • Calcitonin peptide analogues prevent bone loss
  • Parathyroid hormone analogues like teriparatide increase bone formation
  • Lifestyle changes like diet, exercise and fall prevention

A combination of medication and lifestyle approaches provides comprehensive osteoporosis management. Treatment plans are tailored to each patient.

Can You Live with Osteoporosis without Medication?

Non-medical approaches are important but have limits in treating osteoporosis alone without medication. Here are some factors to consider:

  • Lifestyle changes help but may not fully prevent bone loss
  • Nutrition and exercise benefits can decrease but not stop resorption
  • Severe osteoporosis requires medication to strengthen bones
  • Non-drug approaches prevent fractures best along with medication
  • Discuss the pros and cons of all treatment options with your doctor

Lifestyle adjustments complement medication treatment but are often inadequate alone, especially in advanced osteoporosis. Combination plans optimise outcomes.

What Is the Life Expectancy of a Person with Osteoporosis?

Those with osteoporosis can live a normal lifespan with proper treatment and fracture prevention. However, fractures may impact the quality of life and lead to reduced mobility and independence. Hip fractures in particular carry the highest mortality risk and most life impairment.

Early screening and treatment prevent complications of fractures. While osteoporosis alone does not reduce lifespan Proper medication and lifestyle changes allow normal lifespan. Proactive management is key.

What Are the Complications of Osteoporosis?

The main complication of osteoporosis is an increased risk of bone fractures, especially in the spine, hips and wrists. This can lead to other problems, such as the following;

  • Fractures, particularly hip fractures, increase mortality risk
  • Spinal fractures can cause back pain, height loss, and stooped posture
  • All fractures reduce mobility and limit independence
  • Hospitalisation, surgery, and rehabilitation may be needed after fractures
  • Osteoporosis can impair the quality of life through pain, disability, or depression

Fractures severely impact well-being. Monitoring bone health and preventing falls and injuries is crucial to avoid osteoporosis complications.

What Is the Best Way to Increase Bone Density?

 A comprehensive approach combining medications with lifestyle changes is ideal for building bone density in osteoporosis. Here are some tips that your doctor may recommend:

  • Take bone-strengthening medications like bisphosphonates if recommended
  • Get adequate calcium (1200-1500 mg/day) and vitamin D (800-1000 IU/day)
  • Perform weight-bearing and resistance exercises such as deadlifts and squats
  • Eat a balanced diet and track your protein, zinc, and magnesium intake
  • Don’t smoke
  • Avoid alcohol

Boosting bone density requires medication, proper nutrition, and a bone-supporting lifestyle. Consistency is key to the best results.

Can Osteoporosis Be Prevented?

Osteoporosis can often be prevented by building strong bones earlier in life and maintaining bone health through ageing. Here’s how:

  • Optimise bone mass before age 30 by consuming enough calcium and vitamin D and doing bone-strengthening exercises
  • Treat underlying medical conditions like hyperthyroidism or hyperparathyroidism
  • Take bisphosphonates or oestrogen therapy if at high risk for rapid bone loss
  • Get recommended screenings through ageing to detect low bone density
  • Implement fall prevention strategies and avoid smoking and excess alcohol
  • Follow treatment plans to halt bone loss and strengthen fragile bones

Osteoporosis prevention requires lifelong attention to diet, exercise, medications, screenings, and lifestyle habits. But it can be done.

Can Vitamin D Reverse Osteoporosis?

Vitamin D alone cannot reverse osteoporosis, but it plays an important role in facilitating proper bone formation and density. Let’s take a look at the key points you should know about vitamin D:

  • Vitamin D promotes calcium absorption and bone mineralisation
  • Deficiency is linked to accelerated bone loss and altered bone structure
  • Supplements may reduce fracture risk by improving bone quality
  • Maximum effects require adequate calcium intake and weight-bearing exercise
  • Use caution with excessive vitamin D which can cause toxicity
  • Vitamin D works best alongside osteoporosis medications

Vitamin D supplementation supports osteoporosis treatment regimens but is not a cure-all alone. Optimising vitamin D status is one piece of fracture prevention.

Can Walking Reverse Osteoporosis?

Walking cannot reverse osteoporosis damage, but it provides weight-bearing activity that can slow bone loss and improve strength. Here are some key facts you should know about the connection between walking and osteoporosis:

  • Walking is low impact but applies forces that stimulate bone growth
  • Walking may maintain or slightly increase bone density over time
  • The best results come from brisk walking at least 30 minutes per day
  • Combine with strength training and balance exercises for greater benefit
  • Impact is site-specific so the spine requires other exercises
  • Medication is still needed to rebuild bone in osteoporosis

Walking supports overall bone health but does not replace needed treatment for osteoporosis. Pair it with medication, strength training, nutrition, and fall prevention as part of a comprehensive plan. Check out these 10 daily exercises for building strength and muscles.

How to Prevent Falls

Fall prevention is a crucial component of managing osteoporosis. Falls significantly increase fracture risk leading to major complications. Here’s what to keep in mind:

  • Do balance and strength exercises to improve stability and prevent falls
  • Have vision checked and update eyeglasses if needed
  • Remove tripping hazards like cords, area rugs, and clutter
  • Install grab bars, railings, and non-slip surfaces in bathrooms
  • Use assistive devices like canes or walkers for stability if needed
  • Review medications with a doctor that may cause drowsiness or dizziness

Multiple strategies reduce the chances of falling to minimise fracture likelihood. Prioritising fall prevention helps control osteoporosis outcomes.

How to Recover from a Broken Bone

Recovering from an osteoporosis-related broken bone requires prompt treatment and rehabilitation to restore function and mobility. Here are the key steps.

  • Seek emergency care for severe pain, deformity, or inability to move broken bone.
  • Follow doctor recommendations for orthopaedic surgery, casting, bracing, or other care.
  • Attend physical therapy once the bone begins healing to rebuild strength and balance.
  • Make home modifications like adding rails and eliminating fall hazards. 
  • Take calcium and vitamin D supplements to aid continued bone healing.
  • Quit smoking and avoid alcohol to optimise bone formation.
  • Communicate with your healthcare provider throughout the recovery process.

Broken bones from osteoporosis need immediate, appropriate care and supervised rehabilitation. Communicate concerns and follow recommendations diligently for the best recovery.

Finding an Osteoporosis Specialist in Singapore

Wondering how to know if you have osteoporosis? Or maybe you have been diagnosed with osteoporosis and feel like your treatment plan isn’t on track. Whatever you may be dealing with, we are here to help. Send an email to, call +65 6235 8781, or chat with us on WhatsApp at +65 8028 4572. 

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Dr. James - Orthopaedic Surgeon in Singapore

About the Author

Dr James Tan is a highly skilled orthopaedic surgeon who has more than 10 years of experience in sports surgery and exercise medicine. He is a member of the elite Asian Shoulder and Elbow Group and a founding member of the Singapore Shoulder and Elbow Surgery Society.

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