If you’re diagnosed with osteoporosis following a low-impact fracture, then the fracture will need to be treated first. The next step is to begin treatment to reduce your risk of further fractures.
Treatment of fractures
Most fractures are first treated in A&E, and you'll usually have a follow-up appointment at a fracture clinic to see how things are going.
Unless you have a vertebral compression fracture, you'll probably have a cast on the affected area to stop it moving and allow the fracture to heal. In some cases the fracture may need to be manipulated by a specialist before the cast is put on. This may be done in A&E or you may be admitted to hospital. You're also likely to be admitted to hospital if the fracture needs surgical fixing.
It's likely that you'll need pain relief medications, for example:
Prevention of fractures
Self-help measures such as diet and weight-bearing exercise can help to reduce your risk of fractures, but a number of specific treatments are also available.
You're likely to have a bone density scan before you start treatment, although this may not be needed, for example if you're 75 or over. Once you've started treatment your bone density may be monitored in one of the following ways:
- bone density scans, usually of the spine and/or hips, every 2–5 years depending on your individual circumstances.
- blood and urine tests to show how well your bone is renewing itself – these aren't so widely available as bone density scans.
If you're taking hormone replacement therapy (HRT), you'll also have regular blood pressure checks and breast scans (mammograms).
Your bone density should start to improve after 6–12 months, although you may need longer-term treatment to further reduce your fracture risk.
Bone renewal is a slow process so it's important to continue treatment as your doctor advises – even though you won't be able to feel whether it's working.
Because longer-term treatment can sometimes have side-effects your doctor may suggest a break from your treatment after 3–5 years. The benefits of osteoporosis treatment last a long time so these won't be lost if your doctor does suggest a 'treatment holiday'.
Your treatment will depend on your individual circumstances, and you should discuss this with your doctor. Types of treatment include:
Another drug sometimes used to treat osteoporosis, strontium ranelate, was discontinued in August 2017. If you are currently taking strontium ranelate you should arrange to see your doctor to discuss other treatment options that may be suitable for you.