Understanding osteoporosis - diagnosis and treatment

Understanding osteoporosis treatment is vital for everyone, particularly if you have risk factors for osteoporosis.  Osteoporosis treatment includes a multi-faceted programme of diet, lifestyle habits and osteoporosis medication in order to prevent further bone loss and fractures.

Is loss of height a sign of osteoporosis?

If your doctor suspects that you have osteoporosis, he or she may measure you to check for loss of height. Because the vertebrae in the spine are often the first bones affected by osteoporosis or bone loss, you could lose one centimetre or more in height.

If you do have loss of height, your doctor may recommend that you have a bone density test. Although osteoporosis is sometimes diagnosed incidentally after an X-ray has been taken for a fracture or an illness, the usefulness of an X-ray is limited for early screening of osteoporosis.

A bone density scan, also known as a DXA scan, is the most common tool used to measure bone density and diagnose bone loss and osteoporosis at an early stage. 

In addition to these bone density tests, you may be asked to supply blood or urine samples for analysis so your doctor can test for disease-related causes that can cause bone loss.

Can osteoporois be prevented?

Because osteoporosis is difficult to reverse, prevention is the key to preventing painful fractures.

A healthy diet rich in calcium is the cornerstone of prevention. The UK recommended intake of calcium is at least 700mg a day - the equivalent of a pint of milk. Calcium can also be found in leafy green vegetables, dried fruit, tofu and yoghurt.

Vitamin D is also important as it helps your body to absorb calcium. The NHS says a short exposure to sunlight, without sunscreen (10 minutes twice a day) during the summer months should provide you with enough vitamin D to last the whole year. Some groups of people - those who are housebound or with a poor diet for example - may not get enough vitamin D naturally. If you are at risk of not getting enough vitamin D through your diet or lifestyle, seek medical advice about vitamin D supplements.

A regular exercise programme - including weight-bearing exercise, such as walking and aerobics - can help keep your bones strong and free of fractures. Adults are advised to do at least 150 minutes of moderate-intensity aerobic activity such as cycling or brisk walking every week.

What about hormone replacement therapy for osteoporosis treatment?

Hormone replacement therapy (HRT), either oestrogen alone or a combination of oestrogen and progesterone, used to be prescribed for the prevention and treatment of osteoporosis. However, in 2002, a landmark study revealed that hormone replacement therapy increases the risk of breast cancer, heart disease and stroke in some women. So while hormone replacement therapy is known to help preserve bone and prevent fractures, it isn't generally recommended at this point for treating osteoporosis because the health risks are thought to outweigh the benefits.

Findings show that in women who once took menopausal hormone replacement therapy and then stopped taking it, their bones begin to thin again at the same pace as during menopause.

What are some osteoporosis medications?

Alendronate, etidronate, risedronate, strontium ranelate and raloxifene may be prescribed for preventing bone fractures in postmenopausal women with osteoporosis who have not had a fracture.

Alendronate, etidronate, risedronate, raloxifene, strontium ranelate and teriparatide may be prescribed for preventing bone fractures in postmenopausal women with osteoporosis who have already had a fracture.