Health Insights · Endocrine & metabolic
Osteoporosis: protecting your bones
Osteoporosis thins the bone until fractures occur from minor falls or, in the spine, from nothing at all. It causes no symptoms until then. The most important fact about it is that a first fragility fracture roughly doubles the risk of the next — and that is precisely the point at which treatment is most often not started.
Seek urgent assessment if you have
- sudden severe back pain, particularly after a minor movement or with loss of height
- back pain with leg weakness, numbness, or bladder or bowel changes
- a fracture after a fall from standing height or less
- back pain with fever, weight loss, or a history of cancer
- severe pain preventing you standing or walking after a fall
A vertebral compression fracture can occur with trivial force and is often dismissed as muscular back pain. Sudden severe back pain in anyone over 50, or in someone on long-term steroids, warrants imaging rather than analgesia alone.
Who should be assessed
- anyone over 50 who has broken a bone after a fall from standing height or less
- women over 65 and men over 75
- early menopause (before 45), or absent periods for a prolonged period
- long-term oral steroids — three months or more
- a parent who fractured a hip
- low body weight, smoking, heavy alcohol use
- rheumatoid arthritis, coeliac disease, inflammatory bowel disease, overactive thyroid, or previous bariatric surgery
- certain medicines, including some breast and prostate cancer treatments and long-term acid suppression
How it is assessed
A fracture risk calculator combines your risk factors to estimate your ten-year probability of fracture, and a DEXA scan measures bone density at the hip and spine. The scan takes about fifteen minutes, involves very little radiation and requires no preparation. Together they determine whether treatment is worthwhile.
The treatment gap after a first fracture
Most people who break a wrist, hip or vertebra after a minor fall are treated for the fracture and never assessed for osteoporosis — and the fracture itself was the clearest possible warning. If you are over 50 and have broken a bone in a way that would not have broken a healthy bone, ask specifically for a bone health assessment. Do not wait to be offered one.
Treatment
- Bisphosphonates (alendronate, risedronate, or an annual zoledronate infusion) are first line and reduce fracture risk substantially.
- Weekly tablets must be taken on an empty stomach, with a full glass of plain water, sitting or standing upright for 30 minutes afterwards and nothing else by mouth. Taken incorrectly they do not absorb and can irritate the oesophagus.
- Denosumab, a six-monthly injection, is an alternative — but it must not be stopped without replacement treatment, as rebound vertebral fractures can occur.
- Anabolic treatments that build bone are available for severe osteoporosis.
- HRT protects bone and is particularly relevant for women with early menopause.
- Treatment is usually reviewed after three to five years — a 'drug holiday' may be appropriate for some, but that is a decision to be made, not a drift.
What you can do
Builds and protects bone
- Weight-bearing exercise — walking, jogging, dancing, stair climbing
- Resistance training twice a week, which also improves balance
- Calcium from food: dairy, fortified alternatives, tinned fish with bones, green vegetables
- Vitamin D supplementation, particularly October to March
- Balance work such as tai chi, which reduces falls
Weakens it
- Smoking, which has a direct and substantial effect
- More than 14 units of alcohol a week
- Being significantly underweight
- Prolonged immobility
- Untreated coeliac disease or eating disorder
Preventing falls
Most fractures happen because someone falls. Have your eyesight checked, review medicines that cause dizziness, remove loose rugs and trailing cables, improve lighting on stairs, wear well-fitting shoes indoors, and take balance and strength exercise seriously. Falls prevention is as important as any tablet.
Book an appointment if you have broken a bone after a minor fall, have risk factors, are on long-term steroids, or went through the menopause early. We carry out fracture risk assessment, vitamin D and calcium testing and treatment on site, and arrange DEXA scanning through our CQC-registered partners.
Private bone health and osteoporosis assessment in London
Osteoporosis weakens bones and raises fracture risk, usually without symptoms until a bone breaks — so assessing risk matters, especially after menopause or a low-impact fracture. A private GP in East London can assess your risk, arrange blood tests and a bone density scan referral, and advise on treatment and prevention. Tower Bridge Hospital is on Whitechapel Road in East London, a short journey from Canary Wharf and the City, with same-day appointments and no referral required.
Osteoporosis in London: common questions
Who is at risk of osteoporosis?
Risk rises after the menopause and with age, steroid use, low body weight, smoking, and a family history.
How is it diagnosed?
With a bone density (DEXA) scan and a risk assessment; blood tests check for contributing factors.
How is osteoporosis treated?
With bone-strengthening medication where needed, plus calcium, vitamin D, exercise and fall prevention.
Can I be seen the same day?
Yes — same-day private GP appointments are available most days.
Bone health assessment and fracture risk
7 days a week, 9am–7pm, on Whitechapel Road.