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Osteoporosis
Thin, weak bones that break too easily — silent until a fracture. Very common, very treatable, and especially important if you take steroids.
What is osteoporosis?
Osteoporosis means the bones have become thin and weak, so they break with little force — a fall from standing height, a bump, sometimes even a cough or bending forward. It has no symptoms until a fracture happens, which is why it is called a silent disease. The wrist, spine and hip are the most common places to break.
It is very common after menopause and in older men, and it is an important issue in rheumatology because long-term steroid treatment and inflammatory arthritis both thin the bones.
Who is at risk
- Women after menopause, especially early menopause
- Age over 65 in women and over 70 in men
- Steroid tablets (prednisolone, deflazacort) for 3 months or more
- Rheumatoid arthritis and other inflammatory diseases
- Low body weight; a parent who broke a hip
- Smoking, regular alcohol, very little physical activity
- Low vitamin D and low calcium intake — both common in India
- Thyroid overactivity, overactive parathyroid glands, chronic kidney or liver disease, some cancer treatments
On steroids for three months or more? Ask your doctor about bone protection — calcium, vitamin D, and often a bone-strengthening medicine.
Warning signs
- A fracture after a minor fall
- Loss of height of more than 3–4 cm
- A new stooped or rounded upper back
- Sudden back pain after lifting or bending (possible spinal fracture)
How it is diagnosed
- DEXA scan (bone density) of the hip and spine — a T-score of −2.5 or lower means osteoporosis
- FRAX — a calculation of 10-year fracture risk from your risk factors
- Blood tests to find treatable causes: calcium, vitamin D, kidney and liver function, thyroid, parathyroid hormone, and others as needed
- Spine X-ray if a silent spinal fracture is suspected
How it is treated
- Calcium from diet first (milk, curd, paneer, ragi, sesame), with supplements if intake is low
- Vitamin D if levels are low
- Weight-bearing exercise and muscle strengthening; balance training to prevent falls
- Fall-proofing the home — lighting, grab rails, no loose rugs, good footwear
- Bone-strengthening medicines: weekly bisphosphonate tablets (e.g. alendronate) or a yearly zoledronic acid drip; denosumab injection every 6 months; teriparatide daily injections for severe cases
Denosumab must not be stopped suddenly — stopping without a follow-on treatment can cause rapid bone loss and spinal fractures. Always plan the next step with your doctor.
Useful tools: Steroid dose converter (doctors) · Lab unit converter
Common questions
Can osteoporosis be reversed?+
Treatment can increase bone density and substantially lower fracture risk. The bone may not return to its youthful strength, but the risk of breaking it falls considerably.
Is calcium enough to treat osteoporosis?+
Calcium and vitamin D are the foundation, but on their own they are not enough for established osteoporosis. Most people also need a bone-strengthening medicine.
Do steroids cause osteoporosis?+
Yes — bone loss is fastest in the first months of steroid treatment. Anyone on steroids for three months or more should have their bone health assessed.
On steroids, or worried about your bones?
A bone health assessment is quick and can prevent fractures. Walk-in, no appointment needed.
Clinic timings & location