How Likely Is It That I Will Break a Bone If I Have Osteoporosis?

Overview

Just as a twig is easier to break than a branch, so it goes with thin bones versus thick.

If you’re living with osteoporosis, you’ve learned that your bones are thinner than is ideal for your age. This puts you at greater risk for experiencing bone fractures or breakages. But knowing that you’re at risk for breaking a bone and actually breaking one are very different things.

Taking steps to strengthen your bones after you’ve received an osteoporosis diagnosis can help to reduce the risk for future fractures.

The incidence of certain fractures dramatically increases as a person ages. These include fractures to the hip, vertebrae, and forearm and are most often due to osteoporosis. Consider these facts related to osteoporosis and fracture risk:

• An estimated 8.9 million fractures worldwide can be attributed to osteoporosis. This means an osteoporosis-related fracture happens about every three seconds.
• An estimated one in three women worldwide who are older than age 50 will experience a fracture related to osteoporosis. This number decreases for men, with an estimated one in five in the same age group experiencing an osteoporosis-related fracture.
• A 10 percent loss in bone mass in a person’s vertebrae doubles their risk for a vertebral fracture. Losing 10 percent bone mass in the hip increases a person’s risk for fracture by 2.5 times.

These statistics support the knowledge that having osteoporosis increases risk for hip fractures. Women older than age 65 are especially vulnerable: They’ve gone through menopause, so their bones tend to be thinner than men’s.

However, having osteoporosis doesn’t mean that breaking a bone is inevitable.

Osteoporosis is only one part of the puzzle that helps a person with osteoporosis understand their fracture risk. In addition to low bone density, examples of fracture risk factors include:

• high alcohol intake, such as more than four drinks per day; this doubles the risk for hip fractures, according to the International Osteoporosis Foundation
• long-term use of proton-pump inhibiting drugs, such as omeprazole (Prilosec, Prilosec OTC), aspirin and omeprazole (Yosprala), and lansoprazole (Prevacid, Prevacid IV, Prevacid 24-Hour)
• low body weight
• physical inactivity or a sedentary lifestyle
• prolonged use of corticosteroid medications to reduce inflammation, such as methylprednisolone
• smoking
• use of certain medications, such as anxiety-relieving drugs, sedatives, and antidepressants

If you’ve received an osteoporosis diagnosis, talk to your doctor about steps you can take to reduce bone fracture risk. These may include medications for treating the condition as well as lifestyle changes.

Three types of fractures are commonly experienced by those with osteoporosis: vertebral, forearm and wrist, and hip fractures.

Vertebral fractures

A common fracture type for women with osteoporosis is one they may not know about — a vertebral fracture. According to the American Academy of Orthopaedic Surgeons, an estimated 700,000 Americans experience spinal fractures annually.

Vertebral fractures are twice as common as broken hips and wrists. They occur when you break one of the bones in your spine, known as a vertebra. Symptoms associated with a vertebral fracture include:

• difficulty moving around
• height loss
• pain
• stooped posture

Some people don’t experience any pain at all when a vertebral fracture occurs. However, others may start to lose height or experience a curve in their spine known as kyphosis.

Most often, falls cause vertebral fractures. But they can also occur from everyday tasks, such as reaching, twisting, or even sneezing. Certain actions that transmit enough force to the spine, such as driving across railroad tracks, may cause vertebral fractures as well.

Forearm and wrist fractures

Often the result of a fall, wrist and forearm fractures are another common fracture type for women with osteoporosis. An estimated 80 percent of all forearm fractures occur in women.

Hip fracture

Age increases your risk of hip fractures. Of all the people hospitalized for hip fractures, 80 percent are 65 or older. About 72 percent of hip fractures in people age 65 or older were female.

Osteoporosis already signifies weakened bones. When the impact of a fall affects the hip joint of a person with osteoporosis, a fracture can occur.

Hip fractures require surgery as well as postsurgical rehabilitation to heal and restore mobility.

Hormones in the human body can greatly impact bone building and strength. Three of the most important hormones related to bone growth and maintenance include estrogen, parathyroid hormone, and testosterone. However, testosterone doesn’t impact bones as much as the other two hormones.

Estrogen is thought to stimulate osteoblasts, which are bone-growing cells. Estrogen also seems to inhibit osteoclasts, which are cells that break down bone.

After menopause, a woman’s ovaries stop making estrogen. Although the human body makes estrogen in other places, such as fatty tissue, the ovaries are typically a woman’s primary source for estrogen.

The dramatic drops in estrogen that occur after a woman goes through menopause can lead to significant bone loss.

Some risk factors for bone fractures are unavoidable — such as being older than 65, being female, or having a family history of osteoporosis. However, there are lifestyle changes you can make to decrease your risk of bone fractures, such as quitting smoking.

Here are a few other tips to reduce risks for bone fractures when you have osteoporosis:

Fall prevention

Because falls are a contributing factor to osteoporosis-related fractures, anyone living with osteoporosis should take steps like the following to prevent falls:

• Provide sufficient lighting in all rooms. Place nightlights in hallways and rooms.
• Keep a flashlight near your bed to help light a pathway.
• Keep electric cords out of the way of common pathways through your house.
• Remove clutter from living areas, such as books, magazines, or small pieces of furniture that are easy to trip over.
• Install “grab bars” on the bathroom walls near your bathtub and toilet.
• Refrain from walking in socks, stockings, or slippers. Instead, wear rubber-soled shoes to prevent falls.
• Place carpet runners or plastic runners on slippery floors.
• Walk on grass instead of sidewalks slippery from rain, snow, or fallen leaves.
• Remove throw rugs in your home that might slip.

Dietary changes

Calcium and vitamin D are two important components of strong bones. Low intakes of either can be harmful to bone health. According to the National Institutes of Health, insufficient calcium intake is a contributing factor to bone fractures.

Women age 51 and older should consume at least 1,200 milligrams of calcium each day. Calcium-containing foods include low-fat dairy options, such as milk, yogurt, and cheese. Many other nondairy calcium sources exist. Examples include:

• broccoli
• bok choy
• collard greens
• tofu
• calcium-fortified foods, such as orange juice, cereal, and bread

Vitamin D is important to enhancing calcium absorption, yet there are few natural sources of the vitamin. These include:

• egg yolks
• liver
• saltwater fish

However, many foods are fortified with vitamin D, including orange juice, cereals, and whole-grain breads.

Reducing alcohol intake can decrease risks for falls as well as the impact of alcohol on bone loss.

Exercise

Physical activity can enhance strong bones as well as improve balance, reducing the risk for falls. Those with osteoporosis shouldn’t refrain from exercising for fear of falling.

Resistance exercises, such as using exercise bands or small hand weights, can help to build strength. Flexibility exercises, such as yoga, tai chi, or gentle stretching, can improve range of motion and balance.

Always talk to your doctor before beginning any exercise program. If you have osteoporosis, you should avoid activities that require twisting or bending forward from your waist. Such movements may place too much strain on your back and increase the risks for falling. Examples include full sit-ups and toe touches.

Osteoporosis can increase bone fracture risk. But there are many steps people with osteoporosis can take to reduce fracture risk and live healthily. In addition to lifestyle measures to prevent falls and strengthen bones, medications are available to treat osteoporosis.