Rehabify
In brief
- Osteoporosis means thin, weak bones that break easily. It causes no symptoms until a bone breaks.
- Women after menopause and men over 50 with risk factors should ask their doctor about testing, usually a bone density (DEXA) scan.
- The right exercise, enough calcium, protein and vitamin D, medicines your doctor may prescribe, and fall prevention all lower the chance of a fracture.
- At Rehabify in Bengaluru, Dr. Dharshan N A, a physiatrist, assesses bone health and fall risk and plans safe exercise.
What osteoporosis is
Bone is living tissue that is always being broken down and rebuilt. After about the age of 35, we slowly lose more bone than we build. In women, this loss speeds up for several years after menopause. When bones become thin enough to break after a minor fall, or even a cough or a bend, this is called osteoporosis.
The most common fractures are in the hip, the spine and the wrist. A hip fracture often needs surgery and a long recovery. Spine fractures may cause sudden back pain, or happen quietly and show up only as loss of height or a curved upper back.
Who should be tested
Talk to your doctor about a bone health check if you are over 50 and have any of these:
- A broken bone after a minor fall from standing height or less
- Loss of height, a stooped back, or new back pain without an injury
- Early menopause, before 45
- Long-term steroid tablets, or some other medicines your doctor will ask about
- A parent who broke a hip
- Low body weight, smoking or heavy alcohol use
- Rheumatoid arthritis, thyroid problems, diabetes, kidney or liver disease, or conditions that affect how food is absorbed
Women over 65 and men over 70 are often checked even without other risk factors.
What the tests involve
- A fracture risk assessment. The doctor uses your age, sex, weight, past fractures and other risk factors to estimate your chance of a fracture over the next 10 years. Tools such as FRAX, developed with the WHO, help with this.
- A DEXA scan. A quick, painless scan with a very low dose of radiation that measures bone density, usually at the hip and spine. The result is given as a T-score. A lower score means thinner bone.
- Blood tests, such as calcium, vitamin D, kidney and thyroid tests, to look for causes that can be treated.
- Spine X-rays if a fracture is suspected.
The doctor uses all of these together, not a single number, to decide whether you need treatment.
Exercise that helps bones
Bones respond to load. Muscles that pull on bones, and the impact of walking, help keep bones stronger. Exercise also improves balance, which matters just as much, because most hip and wrist fractures follow a fall.
A good programme often includes:
- Strength training two or three times a week for the legs, hips, back and arms, using body weight, resistance bands or light weights
- Weight-bearing activity such as brisk walking or climbing stairs, as your joints allow
- Balance training such as standing on one leg near a support, heel-to-toe walking or tai chi
- Posture exercises to strengthen the back muscles and reduce stooping
What to avoid or be careful with:
- Bending forward from the waist with a load, such as lifting a bucket of water or a heavy bag
- Sudden or forceful twisting of the spine
- Some yoga poses with deep forward bends or twists, if you have had a spine fracture. Ask your doctor which poses are safe.
- High-impact jumping, if you have had fractures or have very low bone density
Start gently and build up over weeks. A physiotherapist can teach safe ways to bend, lift and get up from the floor.
Food, sunlight and medicines
- Calcium from milk, curd, paneer, ragi, sesame, green leafy vegetables and pulses. Your doctor will advise if supplements are needed.
- Vitamin D from careful sun exposure and, often, supplements. Low vitamin D is common in India even in sunny cities.
- Protein at each meal, to support muscles and bones.
- Stop smoking and limit alcohol.
- Medicines your doctor may prescribe to slow bone loss or help build bone. These are chosen based on your fracture risk, other health conditions and other medicines. Do not start or stop any of them without talking to your doctor.
Fall prevention is fracture prevention
Strong bones are only part of the story. Lowering the chance of a fall protects the hip, wrist and spine directly:
- Keep up regular strength and balance exercise
- Ask for a review of medicines that cause dizziness or drowsiness
- Make the bathroom, stairs and night-time path safer
- Wear well-fitting, non-slip footwear
- Have eyes checked, and use a walking aid if one is advised
How Rehabify helps
Dr. Dharshan N A reviews past fractures, falls, medicines, diet and activity, examines posture, strength and balance, and arranges a DEXA scan and blood tests when needed. You leave with a bone health plan, safe home exercises and fall prevention advice. After a spine fracture, the plan includes pain management and rehab to get moving again.
When to get help urgently
Common questions
At what age should I get a DEXA scan?
Many guidelines suggest testing women from 65 and men from 70, and earlier for people over 50 with risk factors such as a fracture after a minor fall, early menopause or long-term steroid tablets. Your doctor will advise when a scan is useful and how often it should be repeated.
I have osteoporosis. Can I still walk and exercise?
Yes, and you should. Walking, strength training and balance exercise help both bones and steadiness. Avoid bending forward with a load and sudden twisting. A physiotherapist can show you safe movements and help you build up step by step, especially after a fracture.
Is calcium and vitamin D enough?
For some people with mild bone loss, it may be part of the plan along with exercise. Many people with osteoporosis also need medicines your doctor may prescribe, plus fall prevention. The right mix depends on your fracture risk, which the doctor will explain after your tests.
Can osteoporosis cause back pain?
Osteoporosis itself does not hurt, but a spine fracture can cause sudden back pain, sometimes after a cough, a bend or no clear injury. Loss of height and a curved upper back can also be signs. New back pain over 50 should be checked by a doctor.
Do men need to worry about osteoporosis?
Yes. Men lose bone too, and about one in five men over 50 may have a fracture linked to osteoporosis in their lifetime. Men are tested less often, so it is frequently missed. A fracture after a minor fall in a man over 50 should prompt a bone health check.
Sources
- [1]
National Institute for Health and Care Excellence (NICE) guideline CG146. Osteoporosis: assessing the risk of fragility fracture
- [2]
International Osteoporosis Foundation (IOF). guidance on osteoporosis, exercise and nutrition
- [3]
Bone Health and Osteoporosis Foundation (formerly the National Osteoporosis Foundation. NOF), Clinician's Guide to Prevention and Treatment of Osteoporosis
- [4]
World Health Organization (WHO). assessment of fracture risk and its application to screening for postmenopausal osteoporosis
This guide is for general education and does not replace a consultation. Read how we write and review guides in our editorial policy.
