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So, you’ve broken a bone. Only those who have experienced a fracture can truly understand how painful and debilitating it can be. Recovering should be your first priority. However, you and your doctor also will want to determine whether this fracture is a symptom of osteoporosis. If you have this underlying disorder, it puts you at greater risk for future fractures. If you are age 50 or older, there is a very good chance your fracture is related to osteoporosis. This fact sheet will help you better understand the relationship between fracture and osteoporosis, so you can take action now to strengthen and protect your bones.
Many people are unaware of the link between a broken bone and osteoporosis. Osteoporosis, or “porous bone,” is a disease characterized by low bone mass. It makes bones fragile and more prone to fractures, especially the bones of the hip, spine, and wrist. Osteoporosis is called a “silent disease” because bone loss occurs without symptoms. People typically do not know that they have osteoporosis until their bones become so weak that a sudden strain, twist, or fall results in a fracture.
In the United States, more than 40 million people either already have osteoporosis or are at high risk due to low bone mass. The disease can occur in both men and women and at any age, but it is most common in older women.
The majority of all hip and spine fractures among older white women can be attributed to underlying bone fragility. Moreover, women near or past menopause who have sustained a fracture in the past are more likely to experience another fracture. Yet, unfortunately, few patients with osteoporotic fractures are referred for an osteoporosis evaluation and medical treatment.
I’ve already had a fracture. Is it too late to talk to my doctor about osteoporosis?
It is never too late. Ideally, you should talk to your doctor during your recovery about whether you might be a candidate for an osteoporosis evaluation. But even if your fracture has healed, you can be evaluated and begin taking steps to protect your bones now.
What kind of doctor should I see about getting an osteoporosis evaluation?
Many different kinds of doctors can evaluate and treat osteoporosis. Start with your primary care doctor or the doctor treating your fracture. He or she probably can conduct the evaluation and may then refer you to a specialist, such as an endocrinologist or rheumatologist, if you require treatment.
What does an osteoporosis evaluation involve?
One thing your doctor will do is ask about your medical history and lifestyle to determine whether you have risk factors for osteoporosis. Some of the factors that increase the risk of developing osteoporosis include personal or family history of fractures; low levels of the hormone estrogen or testosterone; and the use of certain medications, such as glucocorticoids or anti-seizure medications, that may contribute to bone fragility. Your doctor also may want to test your blood or urine and may suggest that you have a bone mineral density test.
What is a bone mineral density test? Is it painful?
A bone mineral density (BMD) test is the best way to determine your bone health. This test can identify osteoporosis, determine your risk for fractures (broken bones), and measure your response to osteoporosis treatment. The most widely recognized BMD test is called a dual-energy x-ray absorptiometry, or DXA test. The test is safe and painless, a bit like having an x-ray, but with much less exposure to radiation. It can measure bone density at your hip and spine and takes only 15 minutes to complete. For a DXA test, you will be asked to lie on a table while a machine above you measures your bone density.
Some private insurance plans will cover BMD tests ordered by your doctor. Medicare also may pay for a BMD test under certain circumstances for women and men age 65 or older. Your doctor and his or her office staff can help you determine if Medicare will cover a BMD test for you.
If I am diagnosed with osteoporosis, what should I do next?
You may feel concerned or even frightened after being diagnosed with osteoporosis. However, the good news is that, armed with information and the support of your doctor, you can significantly improve your bone health and reduce your risk of future fractures with a combination of medication, diet, exercise, and lifestyle modifications.
Some of my friends take medication for osteoporosis. Should I consider this?
Yes. Several medications are available to prevent and treat osteoporosis, including: bisphosphonates; estrogen agonists/antagonists (also called selective estrogen receptor modulators or SERMS); parathyroid hormone; estrogen therapy; hormone therapy; and a recently approved RANK ligand (RANKL) inhibitor. Your doctor can help you understand the benefits and risks of each of these medications and select one that is right for you.
In men, reduced levels of testosterone may be linked to the development of osteoporosis. Men with abnormally low levels of testosterone may be prescribed testosterone replacement therapy to help prevent or slow bone loss.
What else can I do to protect my bones?
In addition to taking your medication, some of the most important things you can do are to follow a diet rich in calcium and vitamin D, maintain an adequate daily intake of protein, monitor your sodium intake, and get plenty of exercise.
I’ve always been active, but I don’t want to risk breaking another bone. Maybe I need to spend more time “on the sidelines” from now on.
It is perfectly understandable that you want to avoid another fracture. No one who has broken a bone wants to revisit that pain and loss of independence. However, living your life “on the sidelines” is not an effective way to protect your bones. Remaining physically active reduces your risk of heart disease, colon cancer, and type 2 diabetes. It may also protect you against prostate and breast cancer, high blood pressure, obesity, and mood disorders such as depression and anxiety. If that isn’t enough to convince you to stay active, consider this: exercise is one of the best ways to preserve your bone density and prevent falls as you age.
What type of exercise is best to reduce my risk of another fracture?
Exercise can reduce your risk of fracturing in two ways—by helping you build and maintain bone density and by enhancing your balance, flexibility, and strength, all of which reduce your chance of falling.
How can I exercise safely if I have osteoporosis?
If you have osteoporosis, it is important for you to get plenty of exercise. However, you will need to choose your activities carefully. Be sure to avoid activities with a high risk of falling, such as skiing or skating; those that have too much impact, such as jogging and jumping rope; and those that cause you to twist or bend, such as golf.
Unfortunately, some people become so afraid of breaking another bone that they become more sedentary, which leads to further loss of bone and muscle. Rest assured, however, that by practicing proper posture and learning the correct way to move, you can protect your bones while remaining physically active. Every activity can be adapted to meet your age, ability, lifestyle, and strength. Your doctor or a physical therapist can help you design a safe and effective exercise program. In the meantime, here are some general guidelines for safe movement:
Before embarking on any exercise program, be sure to consult your doctor.
My fracture happened after I tripped on a rug in my own home. How can I prevent another fall?
Falls are a major source of fractures. The likelihood that you will fall depends on both personal and environmental factors.
What is hip padding? Should I consider it?
Research has shown that hip protectors can decrease the risk of hip fracture among people who are at high risk for falls. Most hip protectors are washable undergarments that fit over the hips. On each side of the garment is a thin layer of lightweight foam plastic. Hip protectors are typically worn by people who have an unstable stride or posture and by people who tend to fall down (with the main impact near the hip) rather than the more typical fall forward (with the main impact on the hands or knees).
However, studies have found that up to one-third of people refused to wear hip protectors or wore them for only limited periods.
Is there anything else I can do?
If you are a smoker, now would be a good time to quit. Tobacco is toxic to your bones, putting you at higher risk for low bone mass and osteoporosis. Excessive alcohol intake also may be damaging to your bones, and people who drink heavily tend to have more bone loss and fractures due to poor nutrition and an increased risk of falling.
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