Select a condition Absence seizures Acne ADHD Age-related macular degeneration AIDS Alzheimer's disease AMD Amebic dysentery Anal tears Angina, stable Angina, unstable Ankle sprain Anorexia Anxiety Appendicitis Arthritis Asthma in adults Asthma in children Athlete's foot Atrial fibrillation Attention deficit hyperactivity disorder (ADHD) Autism Back pain Bacterial vaginosis Bad breath Bedsores Bedwetting Bell's palsy Benign prostatic hyperplasia Bipolar disorder Bladder infection in women Blood pressure Breast cancer Breast pain Bronchiectasis Bronchiolitis Bronchitis Bulimia Bunions Burning mouth syndrome Burns and scalds Canker sores Cardiac arrest Carpal tunnel syndrome Cataracts Cellulitis and erysipelas Chickenpox Childbirth, heavy bleeding Childbirth, tear or cut Chlamydia Chronic bronchitis Chronic fatigue syndrome Chronic obstructive pulmonary disease Chronic prostatitis Chronic tension type headache Cold sores Colic in babies Colon and rectal cancer Colon and rectal cancer screening Colonic diverticular disease Common cold Conjunctivitis Constipation in adults Constipation in children COPD Crib death Deep vein thrombosis Dementia Depression in adults Depression in children Diabetes, type 1 Diabetes, type 2 Diarrhea in adults Diarrhea in children Diverticular disease Ear infection, middle ear Ear infection, outer ear Ear infection with discharge Ear infection with fluid Ear pain during air travel Ear wax Eczema Emphysema Endometriosis Enlarged prostate Epilepsy Episiotomy Erection problems Essential tremor Febrile seizures Fertility problems Fibroids Flu Gallstones Genital herpes Genital warts GERD GERD in children Glaucoma Gonorrhea Gout Group B streptococcus H. pylori infection Halitosis Hay fever Headache, chronic tension type Head lice Heart and circulation problems in diabetes Heart attack Heartburn Heart failure Heavy periods Heel pain Hemorrhoids Hepatitis B Hepatitis C Hernia Herpes, genital Herpes simplex eye infection High blood pressure High blood pressure in pregnancy High cholesterol HIV infection Hyperactivity IBS Incontinence in women Infection in newborn babies Infertility Influenza Insomnia in adults Irritable bowel syndrome Jaundice in newborn babies Jet lag Kidney infection Kidney stones Leg cramps Leg ulcers Lewy body dementia Lung cancer Lyme disease Macular degeneration Malaria prevention Manic depression Mastalgia Measles, mumps and rubella: prevention Melanoma Meniere's disease Meningococcal disease Menopause Migraine in adults Migraine in children MMR prevention Morning sickness Multiple sclerosis Nail infection, fungal Neck pain Nicotine addiction Non-Hodgkin's lymphoma Nosebleeds in children Obesity Obsessive-compulsive disorder OCD Oral thrush Osteoarthritis Osteoporosis Ovarian cancer Painful periods Pancreas cancer Panic attacks Parkinson's disease PCOS Pelvic inflammatory disease Perineal care Peripheral arterial disease Peripheral vascular disease Pneumonia Polycystic ovary syndrome Postpartum depression Postpartum hemorrhage Post-traumatic stress disorder Preeclampsia Pregnancy, nausea Premature birth Pressure sores Prostate cancer Prostatitis, chronic Psoriasis PTSD Raynaud's disease Rectal cancer screening Recurrent cystitis Reflux in children Rheumatoid arthritis Scabies Schizophrenia Seasonal allergy Shoulder pain Sickle cell anemia Sickle cell disease SIDS Sinusitis Skin cancer (melanoma) Skin cancer (squamous cell) Sleep apnea Sleep problems in children Slipped disk Smoking Sore throat Stomach ulcers Stress headache Stress incontinence Stroke, emergency care Stroke prevention Sudden infant death syndrome Swimmer's ear Tennis elbow Tension headache Testicular cancer Thrush (oral) Tic douloureux Tinnitus Tonsillitis Toxoplasmosis in pregnancy Trigeminal neuralgia Underactive thyroid Urinary tract infections in children Varicocele Varicose veins Vascular dementia Warts Whiplash Wisdom teeth, impacted Wrinkles Yeast infection, vagina

Select treatment area Bladder & Kidneys Blood Brain & nervous system Cancer Children's health Diabetes Digestive system Ear, nose & throat Eating & weight Eyes Fertility Heart and circulation Hormones Infections Lungs & breathing Men's health Mental health Mouth Muscles & bones Pregnancy & childbirth Sexual health Skin Sleep Staying healthy Travel health Women's health

If you have osteoporosis, you may worry about your future. Because your bones are weak, you are more likely than average to break one of them. But not everyone who has osteoporosis breaks a bone.

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.¹

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.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.³

• If you are 50 and have osteoporosis, your chances of breaking a bone in the next 10 years are only 5 in 100 (that means only 5 percent).
• If you are 60 and have osteoporosis, your chances of breaking a bone in the next 10 years are more than 20 in 100 (that means more than 20 percent).

You are most likely to break a bone if you have already had one broken bone.⁴

• Of 100 women who have had one hip fracture, 14 get another one.
• Of 100 women who have had a wrist fracture, 10 get another.
• Of 100 women who have a fracture of their spine, 25 get several more.

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.

• If you break a bone in your spine, the other bones in your spine are under more stress.
• If you break a bone in your hip, you may have problems walking and be more likely to fall again.
• If you break a bone once, it makes the bone weaker and more likely to break again.

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.⁵

Some treatments can lower your risk of breaking a bone by half. For example, studies show that in women with osteoporosis:¹

• About 15 in 1,000 women who take a drug called alendronate break a bone
• But 30 in 1,000 women who do not take the drug break a bone.

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.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. The pain is likely to go away in six weeks to eight weeks.⁶ Lots of people get completely back to normal after a fracture of their spine.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.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.⁴

This can cause several problems:

• You may get a backache that won't go away
• You may find it hard to get comfortable in bed, so you have problems sleeping
• If it gets very bad, the organs at the front of your body, like your lungs and bowel, may get squashed. This makes it harder for them to work properly.

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:⁴

• About 3 in 10 people have to go into a nursing home for the first time
• About 4 in 10 people still can't walk on their own
• About 6 in 10 people have problems with everyday tasks like brushing teeth, combing hair and dressing
• About 8 in 10 people can't do other important activities, like driving and shopping.

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.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.⁸

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.