--- title: "Osteoporosis: Symptoms, Causes & Treatment | HealthAnswers" description: "Osteoporosis — fragile bones, fracture risk, DEXA scanning, prevention with calcium, vitamin D, and NHS treatments." url: https://healthanswers.co.uk/conditions/osteoporosis/ robots: noindex --- # Osteoporosis: Symptoms, Causes & Treatment | HealthAnswers Health A–Z Osteoporosis — fragile bones, fracture risk, DEXA scanning, prevention with calcium, vitamin D, and NHS treatments. Written by HealthAnswers editorial team Medically reviewed by [HealthAnswers UK doctor review panel](https://healthanswers.co.uk/our-doctors/) Reviewed 3 July 2026 ## Quick answer What is osteoporosis? Osteoporosis means bones have lost density and strength — fractures occur more easily, often from minor falls. Common in postmenopausal women and older men — often silent until a fracture. Prevention includes weight-bearing exercise, adequate calcium and vitamin D, and not smoking. DEXA scan diagnoses; bisphosphonates and other medicines reduce fracture risk in people at high risk. See a GP after any fracture from standing height or less. ## Who is this page for? This page is for people in the UK who want a plain-English overview of Osteoporosis, including when to seek help and what NHS care usually involves. It explains general information, not what is wrong with you personally. ## Who should skip this page? Skip this page if you need a diagnosis, a prescription, or emergency care. It cannot replace a GP, pharmacist, NHS 111 or 999. If you are in immediate danger, call 999; for urgent advice that is not life-threatening, call 111 in England, Scotland or Wales, or use your GP out-of-hours service in Northern Ireland. On this page 8 sections ## Key facts about osteoporosis - Osteoporosis affects about 3 million people in the UK — many undiagnosed until fracture. - Hip, spine, and wrist fractures most common — vertebral fractures may cause height loss and back pain silently. - FRAX tool and DEXA scan assess fracture risk — treatment offered above threshold. - Bisphosphonates (alendronate) are first-line — take weekly with strict instructions on empty stomach. - Steroids, early menopause, low BMI, and family history increase risk. ## Osteoporosis — weak bones, high fracture risk **Osteoporosis** literally **porous bones** — **low bone mineral density (BMD)** and **disrupted microarchitecture** — **fractures from low trauma** (fall from standing height or less, sometimes **spontaneous vertebral collapse**). Affects **3 million+ UK** — causes **500+ fractures daily** — **hip fracture mortality** significant in elderly. ## Who is at risk **Non-modifiable:** - female sex — especially postmenopausal (oestrogen loss) - age - family history — hip fracture in parent - previous fracture — strongest predictor - early menopause , ** amenorrhoea** **Modifiable:** - low BMI (<19) - smoking , ** excess alcohol** - physical inactivity - low calcium/vitamin D - long-term corticosteroids - ** rheumatoid arthritis**, [hyperthyroidism](https://healthanswers.co.uk/conditions/overactive-thyroid/) **Men:** **20% of hip fractures** — **underdiagnosed**. ## Fractures | Site | Consequence | | --- | --- | | Vertebral | Pain, height loss, kyphosis — may be silent | | Hip | Surgery, loss independence, mortality | | Wrist (Colles’) | Common in postmenopausal women falling forward | **Any low-trauma fracture** → **assess bone health**. ## Diagnosis **FRAX** — 10-year fracture probability — GP online tool. **DEXA scan:** - T-score ≥ -1.0 — normal - -1.0 to -2.5 — osteopenia - ≤ -2.5 — osteoporosis **Treat** based on **FRAX** or **DEXA** plus **fracture history** — NICE thresholds. ## Prevention - weight-bearing exercise — walking, dancing - resistance training — muscle pulls on bone - calcium — diet (dairy, fortified) ~700mg/day — supplement if intake low - vitamin D — see [vitamin D deficiency](https://healthanswers.co.uk/conditions/vitamin-d-deficiency/) - stop smoking , moderate alcohol - fall prevention — home hazards, vision, balance ## Treatment — bisphosphonates first-line **Alendronate 70mg weekly** (or daily risedronate): - empty stomach , plain water , stay upright 30 min - swallow whole — ** oesophageal irritation** risk - dental hygiene — rare osteonecrosis of jaw with long use **Alternatives if intolerant:** - IV zoledronic acid — annual - denosumab — 6-monthly injection — rebound fracture risk if stopped abruptly - raloxifene — breast cancer risk reduction side benefit - teriparatide — build bone — severe osteoporosis — limited course - Romosozumab — specialist **Calcium/vitamin D** co-prescribed unless dietary adequate. ## Menopause link **Oestrogen decline** accelerates bone loss — **HRT** reduces fracture risk — **individual risk-benefit** for [menopause](https://healthanswers.co.uk/conditions/menopause/) symptoms and bone. ## Steroid-induced osteoporosis **≥7.5mg prednisolone ≥3 months** — **bisphosphonate prophylaxis** per guidelines. Osteoporosis is **preventable and treatable** — **fracture is often first sign** — **DEXA and alendronate** after low-trauma break saves independence. ## ! When to see a GP about osteoporosis See a GP if you lose height, develop sudden back pain, or fracture from low trauma — standing height or less. Women over 65 and men over 75 may qualify for DEXA without prior fracture depending on risk. Discuss treatment if on long-term steroids or had early menopause. Seek urgent help for hip fracture — cannot bear weight after fall. ## Common questions about osteoporosis What are the symptoms of osteoporosis? Usually none until fracture — hence "silent disease." Vertebral crush fractures cause sudden back pain, height loss, stooped posture (kyphosis). Hip fracture after minor fall is classic presentation. Dentists sometimes note bone loss on dental X-rays. How is osteoporosis diagnosed? DEXA (DXA) scan measures bone mineral density at hip and spine — T-score -2.5 or below defines osteoporosis. FRAX calculator estimates 10-year fracture risk using risk factors — guides who needs scan and treatment without scan in some cases. What is the best treatment for osteoporosis? First-line alendronate or risedronate bisphosphonates — weekly or monthly tablets — reduce hip and spine fractures. Alternatives — denosumab injections, zoledronic acid infusion, raloxifene, teriparatide for severe cases. Adequate calcium (700mg daily diet + supplement if needed) and vitamin D alongside. Can osteoporosis be reversed? Medicines increase bone density and more importantly reduce fracture risk — partial reversal possible on DEXA but goal is fracture prevention not perfect scan numbers. Lifestyle — weight-bearing exercise, resistance training, stopping smoking — supports bone health lifelong. Who should take vitamin D for bones? UK guidance — everyone consider 10 micrograms (400 IU) daily in autumn/winter; year-round if limited sun, housebound, or covered skin. Higher doses if deficiency proven. Vitamin D alone does not treat established osteoporosis without other treatment if high risk. ## Sources - [NHS — Osteoporosis](https://www.nhs.uk/conditions/osteoporosis/) - [NICE — Osteoporosis fracture prevention](https://www.nice.org.uk/guidance/ta464)