Your Guide to Osteoporosis and Broken Bones: Know Your Risks

Fractures are common in people with osteoporosis because their bones are more fragile than they used to be. The bones most at risk are the hips, wrists, and spinal vertebrae. These breaks may require special treatment.

When you have osteoporosis, your risk of breaking a bone is much higher than usual. Osteoporosis causes your bones to become weak, brittle, and fragile, which means even a minor bump or fall can cause a fracture.

Osteoporosis often leads to fractures in the hips, wrists, and spine. Compression fractures in your spinal column happen because the bones in your spine become too weak to support your body.

Learn more about the most common types of osteoporosis fractures and their symptoms, as well as how you can reduce your risk.

Osteoporosis fractures are breaks that happen because your bones have lost strength and mass over time. Osteoporosis doesn’t have any symptoms, so you may not know you have it until you experience your first fracture.

Osteoporosis is one of the most common causes of fractures in older adults. It’s estimated that at least 1.5 million osteoporosis fractures occur every year. The most commonly seen fractures in people with osteoporosis are hip, wrist, and spinal fractures.

Accidents such as falls can cause bone fractures. However, osteoporosis may weaken bones to the point where seemingly harmless movements, such as coughing, bending, or lifting objects, may lead to fractures. This is especially true of vertical compression fractures (spinal fractures).

When you have osteoporosis, your bones progressively weaken to the point where they become brittle and break easily. The condition is more common in women than in men, but people of all backgrounds are at risk. And that risk increases with age.

Language matters

You’ll notice that the language used to share stats and other data points is pretty binary.

Although we typically avoid language like this, specificity is key when reporting on research participants and clinical findings.

Unfortunately, the studies and surveys referenced in this article didn’t report data on, or include, participants who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.

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Vertebral compression fractures (spinal fractures) develop as a result of weakness in the bones of your spine. Spinal fractures are almost twice as common as other types of fractures related to osteoporosis, like hip and wrist fractures.

You have 24 bones (vertebrae) in your spine. These bones are separated by intervertebral discs, which help act as shock absorbers during movement. Osteoporosis can cause the vertebrae to weaken and lose their shape, becoming narrower and flatter than they used to be. This can sometimes cause older adults to become shorter and develop a rounded back or hump.

Vertical compression fractures happen when the weakened vertebrae are put under too much pressure, causing them to crack. These fractures can happen after a fall or after minor everyday movements, like bending or twisting.

Osteoporosis spinal fractures are often painful, but some people experience no symptoms. You might notice that the pain in your back:

• worsens when you move
• gets better when you rest
• travels to your legs
• may worsen with small movements, such as coughing and sneezing

Diagnosis

To diagnose a spinal fracture, a doctor will first perform a physical exam. They’ll ask you about your symptoms and press on the site of your pain. Additionally, a doctor will analyze your spinal alignment and overall posture.

Next, an imaging test can help confirm a spinal fracture. This may involve an X-ray, a computed tomography (CT) scan, or magnetic resonance imaging (MRI). If you haven’t received an osteoporosis diagnosis, a doctor may order a bone density scan to look for signs of bone loss.

A primary care doctor, emergency room doctor, or another healthcare professional may diagnose an osteoporosis fracture. But in some cases, you may be referred to a specialist such as a rheumatologist or an orthopedist.

While osteoporosis can result in fractures in any bone in your body, your spine, hips, and wrists are considered the most vulnerable.

The most common symptoms of a bone fracture include pain, swelling, and deformity of the affected area. You may also notice snapping or grinding noises when the fracture occurs.

Depending on where the osteoporosis fracture occurs, you might not be able to put weight on the bone. For example, a hip fracture can prevent you from walking, and a broken wrist can make it difficult to move your hand.

Diagnosis

A doctor may diagnose an osteoporosis fracture after ordering imaging tests, such as X-rays, to help identify the fracture. A doctor may also order a bone density test to help confirm a diagnosis of osteoporosis. An accurate diagnosis will help the doctor determine the best treatment plan.

Treating fractures in people with osteoporosis typically involves two steps: treating the acute injury and treating the osteoporosis to help prevent future breaks. Treatment for the break itself will depend on the location and severity of the break.

Treating spinal fractures

In most cases, osteoporosis-related spinal fractures improve on their own, without surgery, within 3 months. Instead of surgery, a doctor might recommend trying rest combined with short-term pain medications.

However, surgery may be required to treat more severe fractures in the spine that cause ongoing pain and mobility challenges. In such cases, a doctor will recommend one of the following:

• Kyphoplasty: This X-ray-guided surgery involves the use of a balloon to create space between the compressed vertebrae. Then, a surgeon fills the fracture in with a cement mix that helps strengthen the spine.
• Vertebroplasty: This procedure is similar to kyphoplasty. The main difference is that bone cement is placed directly within compressed vertebrae without the use of a balloon to make extra space for the cement beforehand.

While you’ll need to undergo general anesthesia for these surgeries, they are minimally invasive and you should be able to resume your normal activities shortly after the procedure.

When considering either procedure, it’s important to know that the results from kyphoplasty may last longer than those from vertebroplasty.

Hip, wrist, and other fractures

A broken hip is a serious injury that can be extremely painful and significantly reduce your mobility. After a hip fracture, most people will need to have surgery within the next day or two. There are several different types of hip fractures that are common among people with osteoporosis, and the surgical approach can be different with each.

The surgeon may use surgical screws and pins to stabilize the joint or they may perform a partial or total hip replacement.

Treatment for wrist fractures also depends on the type of break. Generally, the bones will need to be put back together so that they can heal. Typically, this means aligning the bones and placing a splint or cast. For more severe breaks, you might need surgery. Surgeons will use tools like pins, screws, and plates to hold the bones together.

Treatment for other broken bones will depend on the type and severity of the breaks.

For many people, a broken bone is the first sign of osteoporosis. If a doctor diagnoses osteoporosis after your break, they may prescribe osteoporosis medications to help prevent future breaks.

A doctor should discuss osteoporosis treatment with you soon after your fracture. If you’ve had one broken bone already, you’re at risk of another fracture.

There are several medication options that can help slow down the rate of bone loss and reduce your risk of fracture. Not all medications are safe for everyone, and some of these medications can cause side effects. It’s important to talk with a doctor about the risks and benefits of different osteoporosis medications.

The most commonly prescribed medications for osteoporosis are called bisphosphonates. Bisphosphonates are used to prevent the loss of bone mass. They may be taken orally or by injection. They include:

• alendronate (Fosamax)
• ibandronate (Boniva)
• risedronate (Actonel)
• zoledronic acid (Reclast)

There are other treatment options for people who don’t tolerate bisphosphonates, including hormone-related medications.

Reducing risk factors

Adults over the age of 50 are at the highest risk of developing osteoporosis, with 1 in 5 women being affected. A family history of osteoporosis, as well as hormonal changes during menopause, may also increase your risk.

While age and genetics are out of your control, you can help manage other risk factors for fractures by:

• getting physical activity
• building strength
• improving balance and flexibility
• removing tripping hazards from your living space
• maintaining a moderate weight
• reducing your alcohol intake
• eating a balanced diet
• quitting smoking if you smoke and avoiding secondhand smoke

Vitamins and supplements

If you’re not getting enough vitamin D or calcium in your diet, a doctor may recommend supplemental versions. Dairy products, fish, leafy greens, and fortified foods can also help you get enough of these nutrients.

Exercises to reduce your risk of fracture

Regular physical activity is important in helping to maintain bone strength. It can also increase flexibility and balance, which may in turn help prevent falls.

While weight bearing exercises are particularly important, certain high impact activities, such as running or dancing, aren’t recommended if you’re at high risk of fractures.

Instead, you might consider low impact workouts such as:

• walking
• swimming
• tai chi
• yoga
• resistance training
• strength training

• Osteoporosis fractures develop as a result of weakened, brittle bones.
• These fractures are most common along the spine but can also occur in the wrists, hips, and other areas of the body.
• You can slow the progression of osteoporosis and reduce your risk of fractures with medications and certain lifestyle changes.

Last medically reviewed on March 15, 2023