Osteoporosis: risk, bone density test, treatment and fall prevention
What osteoporosis is, who is at risk, how a DEXA scan measures bone strength, how medicines and exercise prevent fractures, and which doctor to see.
Also known as: Bone Loss
What osteoporosis is
Osteoporosis is a condition in which bones lose density and quality, becoming thinner, weaker and more likely to break. Bone is living tissue that is constantly broken down and rebuilt. After about the age of thirty, the balance slowly tips towards loss, and in osteoporosis the loss goes far enough to make bones fragile.
It is often called a silent disease because there are no symptoms until a bone breaks. The most common fractures are in the spine, hip and wrist. A hip fracture in an older person is serious: it usually needs surgery and can affect independence for a long time.
Osteopenia is a milder loss of bone density. It does not always need medicine, but it is a reason to look at risk factors and to protect bone health.
Signs and symptoms
Osteoporosis usually has no warning signs. It may first show itself as:
- A fracture after a minor fall from standing height or less, or even after a cough, a bump or lifting something
- Loss of height over the years
- A stooped posture or curved upper back
- Sudden back pain, which can be caused by a collapsed vertebra (a spinal compression fracture)
Many spinal fractures cause little pain and are found only on an X-ray. Any fracture from a minor fall in an adult over fifty should prompt a check for osteoporosis.
Causes and who is at risk
Risk is higher if you:
- Are a woman, particularly after menopause, when oestrogen levels fall; early menopause raises risk further
- Are older — men are affected too, usually later in life
- Have a parent who broke a hip
- Have a low body weight or a small frame
- Have taken steroid tablets for a long time
- Have conditions such as rheumatoid arthritis, an overactive thyroid or parathyroid, coeliac disease, chronic kidney or liver disease, or low testosterone
- Get too little calcium, vitamin D, sunlight or physical activity
- Smoke or drink heavily
Some other medicines, including certain anti-seizure medicines, breast and prostate cancer hormone treatments, and long-term high doses of acid-reducing tablets, can also affect bone. Bring a list of your medicines to the appointment.
How it is diagnosed
The standard test is a DEXA scan (dual-energy X-ray absorptiometry). It is a quick, painless low-dose X-ray that measures bone density at the hip and spine. The result is compared with that of healthy young adults, and the doctor will explain whether it falls in the normal, osteopenia or osteoporosis range.
Doctors also estimate your chance of a fracture over the coming years using a tool such as FRAX, which combines bone density with risk factors such as age, previous fractures and steroid use. Heel ultrasound screening at health camps can suggest low bone density but does not replace a DEXA scan.
Blood tests look for causes and check that treatment is safe: calcium, kidney function, thyroid, and vitamin D, which is often low. A spine X-ray may be done to look for hidden fractures.
Which doctor to see
An orthopaedic surgeon treats fractures and often manages osteoporosis afterwards. An endocrinologist is the right choice when hormonal causes are suspected or osteoporosis is severe or unusual. A gynaecologist can assess bone health around menopause. A general physician can arrange the first tests.
You can find orthopaedic surgeons in Bengaluru, endocrinologists and gynaecologists on The Doctor Index.
Treatment
Treatment aims to prevent fractures. Whether you need medicine depends on your overall fracture risk, not on bone density alone. Your doctor will decide based on your scan, risk factors and any previous fractures.
Calcium, vitamin D and lifestyle
Get enough calcium and vitamin D from diet — milk, curd, paneer, ragi, sesame, green leafy vegetables and pulses — and from supplements if your doctor advises. Sensible sun exposure helps vitamin D. Exercise, especially weight-bearing activity such as walking and climbing stairs, plus muscle-strengthening and balance work, keeps bones and muscles strong. Stop smoking and limit alcohol.
Medicines
Bisphosphonates, such as alendronate, risedronate and zoledronic acid, slow bone loss and are the most commonly used medicines. Tablets must be taken exactly as instructed: on an empty stomach with plain water, staying upright afterwards. Denosumab, an injection given at regular intervals, is another option. For very high risk, teriparatide and other bone-building medicines stimulate new bone. Hormone therapy may be suitable for some women around menopause.
Fall prevention
Fall prevention is as important as medicine. Good lighting, non-slip mats in the bathroom, grab bars near the toilet, removing loose rugs and wires, suitable footwear, eye checks, and reviewing medicines that cause dizziness or drowsiness all reduce falls.
Living with osteoporosis
Most people with osteoporosis live active lives. Keep exercising, but avoid sudden heavy lifting or deep forward bending if you have had spinal fractures. A physiotherapist can teach safe movements. Repeat DEXA scans and treatment reviews are usually done every few years. Some people are offered a planned break from bisphosphonates after several years; this is a decision for your doctor.
When it is an emergency
Call 112 or 108, or go to the nearest emergency department, for:
- A fall followed by severe hip or groin pain, being unable to stand or bear weight, or a leg that looks shorter or turned outwards
- Sudden severe back pain with numbness, weakness, or loss of bladder or bowel control
- A fall with a head injury, especially if you take blood thinners
Questions to ask at your appointment
- What is my fracture risk over the coming years?
- Do I need a DEXA scan, and when should it be repeated?
- Is there an underlying cause of my bone loss?
- Do I need medicine, and how long will I take it?
- How should I take my tablets, and what side effects should I watch for?
- What can I do at home to prevent falls?
Common questions
Questions people ask
- Can osteoporosis be reversed?
- Medicines can stop bone loss and some can rebuild bone, which lowers fracture risk substantially. Bone density may improve on treatment, although it rarely returns fully to normal. Exercise, calcium, vitamin D and fall prevention all add to the effect of medicine.
- Is calcium alone enough to treat osteoporosis?
- No. Calcium and vitamin D support bone health and help medicines work, but on their own they do not treat established osteoporosis. People at high fracture risk usually need a medicine such as a bisphosphonate in addition.
- Do men get osteoporosis?
- Yes. Men lose bone too, usually later in life than women. Long-term steroid use, low testosterone, heavy drinking, smoking and some medical conditions raise the risk. A man who breaks a bone after a minor fall should be checked.
- Is a heel scan at a health camp enough?
- A heel ultrasound can flag people who may have low bone density, but it is not used to diagnose osteoporosis or to decide treatment. A DEXA scan of the hip and spine is the standard test.
This condition is usually assessed by an orthopaedic surgeon. Every profile shows the doctor’s registration and what has been checked.
Orthopaedic surgeons in Bangalore
A few orthopaedic surgeons listed on The Doctor Index. They are shown because of their speciality, not a stated interest in Osteoporosis; ask the clinic whether the doctor sees it.
Related conditions
- Bursitis
- Carpal Tunnel Syndrome
- Dislocated Shoulder
- Fractures
- Herniated Disk
- Muscle Cramps
- Rotator Cuff Injuries
- Scoliosis
Practical reading
All postsSources
- MedlinePlus, US National Library of Medicine — Osteoporosis
- International Osteoporosis Foundation — About osteoporosis
- MedlinePlus, National Library of Medicine — Osteoporosis — Public-domain health-topic summary
Osteoporosis: risk, bone density test, treatment and fall prevention is original text by The Doctor Index; the compiled source draft was used for research. Source: MedlinePlus, National Library of Medicine. Orphadata Science: Free access data from Orphanet. © INSERM 1999; July 2026 data, CC BY 4.0. This product uses the Human Phenotype Ontology (hp/releases/2026-09-01). Only sources listed for this article apply. Source material has been selected and arranged; HPO definitions are reproduced without alteration. No source organisation endorses this compilation. Köhler S et al. The Human Phenotype Ontology project: linking molecular biology and disease through phenotype data. Nucleic Acids Research 2014;42(D1):D966–D974. doi:10.1093/nar/gkt1026.
General information, not advice about your situation. Errors can be reported through the corrections process. Reference TDI-C-1776.