Osteoporosis and Fracture Risk: What to Do Now

Osteoporosis is often called a silent disease because bone loss happens gradually and without symptoms until a fracture occurs. According to the Bone Health and Osteoporosis Foundation, more than 54 million Americans have osteoporosis or low bone mass, yet many do not know it until they break a bone from a fall that would not have injured someone with healthy bone density.

As an orthopedic practice that treats fragility fractures throughout Claremont, the Inland Empire, and the Pomona Valley, we see firsthand how much easier these injuries are to prevent than to treat. This guide covers what raises your fracture risk and what you can do about it now, whether or not you have been diagnosed with osteoporosis.

Understanding How Osteoporosis Raises Fracture Risk

Bone is living tissue that is constantly being broken down and rebuilt. Osteoporosis develops when bone breakdown outpaces bone formation, leaving the internal structure of the bone porous and fragile. The National Institutes of Health notes that this process accelerates significantly after menopause in women due to declining estrogen levels, though men develop osteoporosis as well, particularly with age.

The hip, spine, and wrist are the most common fracture sites because of how they absorb force during a fall. A hip fracture in particular can be a serious medical event for older adults, often requiring surgery and a long rehabilitation period.

Who Is Most at Risk

• Postmenopausal women, due to declining estrogen levels
• Adults over age 50, especially with a family history of osteoporosis or fracture
• People with a low body weight or small frame
• Long-term users of corticosteroid medications
• Smokers and people who consume alcohol heavily
• People with a sedentary lifestyle or low calcium and vitamin D intake

A bone density scan, known as a DEXA scan, is the standard tool for measuring bone density and determining whether you have osteopenia (mild bone loss) or osteoporosis. The Bone Health and Osteoporosis Foundation generally recommends screening for women 65 and older and for younger postmenopausal women or men with significant risk factors.

Building Stronger Bones Through Nutrition and Exercise

Calcium and Vitamin D

Calcium is the primary building block of bone, while vitamin D is essential for the body to absorb it. The NIH's Office of Dietary Supplements recommends most adults over 50 aim for 1,000 to 1,200 milligrams of calcium daily from food sources like dairy, leafy greens, and fortified foods, along with adequate vitamin D from sunlight, food, or supplementation.

Weight-Bearing and Resistance Exercise

Weight-bearing activities such as walking, hiking, and strength training stimulate bone formation by applying mechanical stress to the skeleton. Resistance training also builds the muscle strength needed to prevent the falls that most often cause fractures in the first place.

Reducing Fall Risk at Home

Since falls, not the bone loss itself, are what typically cause fractures, reducing fall risk is just as important as improving bone density. Simple home modifications make a measurable difference.

• Remove loose rugs and clutter from walkways
• Install grab bars in the bathroom and adequate lighting on stairs
• Wear supportive, non-slip footwear rather than loose slippers
• Have vision checked regularly, since poor eyesight increases fall risk
• Discuss medications with your doctor that may cause dizziness

What to Expect From a Bone Density Screening

A DEXA scan is quick, painless, and involves far less radiation exposure than a standard X-ray. The scan measures bone density at the hip and spine and compares your results to those of a healthy young adult, generating a T-score that classifies your bone density as normal, osteopenic, or osteoporotic.

If you are diagnosed with low bone density, treatment does not automatically mean medication. Many patients with osteopenia are managed successfully through nutrition, exercise, and fall prevention alone, with medication reserved for those with osteoporosis or a higher calculated fracture risk based on tools like FRAX, which factors in age, prior fractures, and other risk elements alongside bone density.

Follow-up scans are typically recommended every one to two years to track whether your bone density is stable, improving, or continuing to decline, which helps guide whether your current approach needs adjustment.

For patients diagnosed with osteoporosis, several prescription medications can help slow bone loss or, in some cases, actively rebuild bone density. These treatment decisions are typically made jointly between a primary care physician or endocrinologist and, when a fracture has already occurred, an orthopedic surgeon who can address both the acute injury and the underlying bone health issue that contributed to it.

A Word on Calcium Supplements

Food sources of calcium are generally preferred over supplements when possible, since some research has raised questions about high-dose calcium supplementation and cardiovascular risk, an area that is still being studied. Patients who cannot meet their calcium needs through diet alone should discuss appropriate supplement type and dosing with their physician rather than assuming more is automatically better.

Vitamin D supplementation is often more straightforward, since deficiency is common, particularly in people who spend little time outdoors or who have limited sun exposure for other health or lifestyle reasons. A simple blood test can confirm whether your vitamin D level is adequate and guide appropriate supplementation.

The Bottom Line

Osteoporosis does not have to lead to a fracture. Between bone density screening, adequate calcium and vitamin D, regular weight-bearing exercise, and practical fall-prevention steps at home, most people can significantly reduce their risk of a life-altering hip or spine fracture.

Patients who have already broken a bone from a minor fall deserve particular attention, since a first fragility fracture significantly raises the risk of a second one without intervention. This is sometimes an overlooked opportunity to catch and treat osteoporosis before a more serious injury occurs.

If you are over 50, have a family history of osteoporosis, or have already experienced a fracture from a minor fall, our orthopedic team serving Claremont and the greater Inland Empire can help assess your bone health and build a prevention plan tailored to you.