If you have osteoporosis, you are most likely to break a bone in your spine, hip or wrist. When you break a bone, doctors say you have a fracture.

With osteoporosis, your chances of breaking a bone depend on lots of things. We discuss some of those things below.

People with osteoporosis often break a bone when they fall down. So if you have this condition, one way to make a fracture less likely is to try not to fall. For more, see Preventing falls.

Your bone mineral density (BMD for short) tells your doctor how strong (dense) your bones are. It is measured with a DEXA scan. The results are called your T score.

If you have a score lower than -2.5, you have osteoporosis. Without treatment, 12 in 100 people with osteoporosis will break a bone in the next two years.

 

 

 

 

 

Source:
Cranney A, Wells G, Willan A, et al.
Meta-analysis of alendronate for the treatment of postmenopausal women.
Endocrine Reviews. 2002; 23: 508-516.

 

 

 

 

 

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If you have a score of -1 to -2.5, you have osteopenia. This means your bones are weak, but not as weak as in osteoporosis. About 2 in 100 people with osteopenia will break a bone because it's weak in the next year.

 

 

 

 

 

Source:
Siris ES, Chen YT, Abbot TA, et al.
Bone mineral density thresholds for pharmacological intervention to prevent fractures.
Archives of Internal Medicine. 2004; 164: 1108-1112.

 

 

 

 

 

²

But your BMD isn't the only thing that affects your chances of breaking a bone.

Your chances of breaking a bone are lower when you are younger.

 

 

 

 

 

Source:
Raisz LG.
Clinical practice: screening for osteoporosis.
New England Journal of Medicine. 2005; 353: 164-171.

 

 

 

 

 

³

You are most likely to break a bone if you have already had one broken bone.

 

 

 

 

 

Source:
Cooper C.
The crippling consequences of fracture and their impact on quality of life.
American Journal of Medicine. 1997; 103: 12-19.

 

 

 

 

 

⁴

This is partly because breaking a bone means that your bones have gotten weak. But breaking one bone, particularly in your spine, can make it more likely that you will break another one. Here's why.

So it's important to do everything you can to avoid breaking a bone. For more, see Preventing falls.

You have a much lower chance of breaking a bone if you take drugs to stop your bones getting weaker.

 

 

 

 

 

Source:
Nelson HD, Helfand M, Woolf SH, et al.
Screening for post menopausal osteoporosis: a review of the evidence for the US Preventive Services Task Force.
Annals of Internal Medicine. 2002; 137: 529-541.

 

 

 

 

 

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Some treatments can lower your risk of breaking a bone by half. For example, studies show that in women with osteoporosis:

 

 

 

 

 

Source:
Cranney A, Wells G, Willan A, et al.
Meta-analysis of alendronate for the treatment of postmenopausal women.
Endocrine Reviews. 2002; 23: 508-516.

 

 

 

 

 

¹

If you have treatment for osteoporosis, your bones stop getting weaker. They may even get stronger again. This means your risk of breaking a bone may go down the longer you have treatment. But we don't know what happens to your bones if you stop taking the medication.

 

 

 

 

 

Source:
Cranney A, Wells G, Willan A, et al.
Meta-analysis of alendronate for the treatment of postmenopausal women.
Endocrine Reviews. 2002; 23: 508-516.

 

 

 

 

 

¹

Different types of fractures affect people in different ways. For example, a broken wrist hurts. But it doesn't cause as many problems in the long run as a broken hip.

Here are some things that may happen if you break a bone.

This is the most common fracture caused by osteoporosis. It may happen if you fall down. But if your bones are very weak, it could happen just from sneezing or rolling over in bed.

A broken bone in your spine can cause a sharp pain in your back. But sometimes you don't feel anything when the bone first breaks.

If you break a bone in your spine, your doctor may tell you to lie in bed for a few days and take painkillers until it heals. You may need to have

 

 

 

 

 

physical therapy
Physical therapy is a way of using movements or exercises to help your body heal.

 

 

 

 

 

physical therapy. The pain is likely to go away in six weeks to eight weeks.

 

 

 

 

 

Source:
Lindsay R, Silverman SL, Cooper C.
Risk of new vertebral fractures in the year following fracture.
Journal of the American Medical Association. 2001; 285: 320-323.

 

 

 

 

 

⁶ Lots of people get completely back to normal after a fracture of their spine.

 

 

 

 

 

Source:
Old JL, Calvert M.
Vertebral compression fractures in the elderly.
American Family Physician. 2004; 69: 111-116.

 

 

 

 

 

⁷

You can break a bone anywhere along your spine. But it is most common in the middle and lower parts of your back. Between 2 in 10 and 3 in 10 of these fractures affect two or more bones.

 

 

 

 

 

Source:
Old JL, Calvert M.
Vertebral compression fractures in the elderly.
American Family Physician. 2004; 69: 111-116.

 

 

 

 

 

⁷ When this happens, doctors call it a multiple fracture.

If you break a bone in your spine, this puts pressure on all the other bones in your spine. So the other bones are more likely to break too. If several of the bones in your spine break, your spine may hunch over, so you can't stand up straight.

 

 

 

 

 

Source:
Cooper C.
The crippling consequences of fracture and their impact on quality of life.
American Journal of Medicine. 1997; 103: 12-19.

 

 

 

 

 

⁴

This can cause several problems:

For more, see Breaking a bone in your spine.

Most people with osteoporosis break their hips when they fall down. If you break your hip, it hurts a lot. And your leg may swell up. You will need to go to the hospital for treatment. And you will probably need an operation to fix your hip.

Some people get a lot better and can go home and live on their own after surgery. But other people find this harder.

Here is what studies show one year after breaking a hip:

 

 

 

 

 

Source:
Cooper C.
The crippling consequences of fracture and their impact on quality of life.
American Journal of Medicine. 1997; 103: 12-19.

 

 

 

 

 

⁴

Breaking a hip is especially serious for older adults who also have several other illnesses. And older adults are more likely to die after a hip fracture. For more, see Breaking a bone in your hip.

There hasn't been enough research to say for sure why people are more likely to die after a hip fracture. We know the chances of this happening are highest for men and for people with other illnesses. It is also higher the older you are. But for most people, the chances go back to normal for their age two years after the fracture.

 

 

 

 

 

Source:
Cooper C.
The crippling consequences of fracture and their impact on quality of life.
American Journal of Medicine. 1997; 103: 12-19.

 

 

 

 

 

⁴

Fractures in your wrist are far less serious than fractures in your hip or spine. This is because they only affect the way your arm moves, not your general health.

If you break your wrist, you will probably need to stay in the hospital. Your arm may be put in a cast. Or you may need an operation. Most people find their wrist heals up well and they can use it properly again afterward.

 

 

 

 

 

Source:
Lips P, van Schoor NM.
Quality of life in patients with osteoporosis.
Osteoporosis International. 2005; 5: 447-455.

 

 

 

 

 

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