What should you know about involutional osteoporosis?

Bone is continually renewed. With ageing, breakdown can outpace rebuilding, so the skeleton may become less dense and its internal structure less able to absorb everyday loads. The term may describe osteoporosis developing after the body's normal ageing changes rather than from a single injury.

Many people do not feel bone loss itself. The first sign can be a fracture after a minor fall or routine movement. The hip, spine, wrist, and other bones may be affected. Spinal fractures can cause sudden back pain, loss of height, or a more rounded upper back; some cause little pain and are discovered later.

A clinician considers your age, previous fractures, medicines, family history, falls, nutrition, activity, and conditions that affect bone health. A bone density scan can measure bone mineral density, while blood tests may help look for contributing problems such as vitamin D deficiency. Bone density is one part of the assessment, not a prediction of exactly when a fracture will occur.

Arrange a medical assessment if you have risk factors, a fracture after a low-impact event, or new unexplained back pain. Your clinician may recommend a bone density scan and a plan based on your fracture risk and other health needs.

Regular weight-bearing and resistance activity can support strength and balance when suited to your abilities. A physiotherapist can adapt exercises and practise safer movement. Aim for adequate dietary calcium and vitamin D; supplements should be discussed if food intake, absorption, sunlight exposure, or test results suggest they may help. Medicines such as bisphosphonate therapy may be considered for some people.

Reduce falls by improving lighting, clearing loose rugs and cables, using prescribed glasses or walking aids, and reviewing medicines that cause dizziness with a clinician. Avoid smoking, and keep alcohol within medically advised limits.

Seek urgent medical care after a fall or sudden force if you cannot stand or put weight through a limb, have severe hip or back pain, notice a visible deformity, or develop numbness or weakness. A hip fracture can be serious and needs prompt assessment.

Contact a clinician soon about persistent or sudden back pain, a noticeable change in posture, or loss of height, even when there was no obvious fall. These changes can occur with a vertebral compression fracture. Do not start high-impact exercise after a suspected fracture until you have been assessed.

Ask which factors may be affecting your bone health, whether a bone density scan is appropriate, and how often your risk should be reviewed. You can also ask which exercises are suitable, whether your calcium and vitamin D intake is adequate, and how possible treatment benefits and side effects fit your medical history.