What to Do When Osteoporosis Breaks Your Bone

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Osteoporosis can sneak up on you. 

Often with no noticeable symptoms, the bone-weakening disease can gradually and silently take away bone mass.

And then, with a fall or a sudden strain or twist, sometimes caused by nothing more than a hearty sneeze, a bone breaks. For many, a fracture is the first obvious sign of osteoporosis.

Bones in the spine, hip and wrist are most at risk of osteoporosis-related fracture, says Indresh Venkatarayappa, MD, an orthopedic surgeon with Premier Orthopedics

Falls from standing height or less are enough to break bones that have been made fragile by osteoporosis, he says. And the disease can cause the small bones of the spine, the vertebrae, to collapse on one another. 

Preventing Osteoporosis Fractures

Several modifiable risk factors contribute to osteoporosis and osteoporosis-related fractures. These include insufficient dietary calcium and vitamin D, lack of exercise, alcohol abuse, and eating disorders that interfere with nutrition.

Many of the same preventive measures you can take to lower your risk of developing osteoporosis in the first place – to promote bone density – can also reduce the risk of recurring fractures and aid healing of an osteoporosis-related fracture:

  • Calcium: This bone-strengthening mineral is available in dairy products such as milk, cheese and yogurt and nondairy foods such as broccoli, almonds and sardines. And some foods are fortified with calcium. These include juices, breads and cereals. If you don’t get enough calcium in your diet, calcium supplements can help you reach the recommended daily levels: 1,000 milligrams for men and women up to age 50 and 1,200 mg for women over age 50 and men over age 70.
  • Vitamin D: Available in fortified foods, such as milk, and calcium supplements, Vitamin D helps your body absorb calcium. The recommended daily Vitamin D intake is 600 IU (international units) up to age 70 and 800 IU over age 70, for men and women.
  • Sodium and Protein: Consuming too much sodium (as salt and in foods) is a well-recognized risk factor for osteoporosis because it can increase the amount of calcium you lose in the urine. This can harm the bone calcium balance. Low salt intake is recommended. However, protein promotes bone health and healing of fractures, when consumed at recommended daily levels of 56 grams for men and 46 grams for women.
  • Exercise: If you’ve had a fracture related to osteoporosis, you may be wary of exercise, concerned it could put you at risk of another fracture. But the stress of exercise actually helps bones gain mass and strength. 
For many, a fracture is the first obvious sign of osteoporosis.

Some Exercises More Effective Than Others

While exercise is an important component of lowering your risk of fracture, you need to exercise some caution, Dr. Venkatarayappa recommends. For instance, don’t walk outdoors in icy conditions, remove tripping hazards from your home, wear shoes with nonslip soles and avoid exercise and physical activity that involves twisting the spine or bending forward from the waist.

And, Dr. Venkatarayappa says, not all types of exercise have the same degree of impact on bone health. “Aerobic exercise is good for general bone health, but it is not very beneficial for osteoporosis,” he advises.

If you’ve already been diagnosed with osteoporosis or have already had a broken bone due to the disease and want to lower your risk of recurring fractures, he recommends focusing more on resistance and balance exercises in addition to aerobic exercise.

Resistance exercises, such as weight training with free weights or weight machines, put more strength-promoting stress on bones than normal daily activities and other types of exercise. 

Dr. Venkatarayappa adds that exercises that improve balance, such as tai chi, yoga and walking on your heels and toes, should be done initially with supervision due to the risk of falling. Your fall risk will diminish as your strength and balance improve. 

Aerobic weight-bearing exercises, such as walking, dancing, climbing stairs and playing tennis, also strengthen bones, as you work against the resistance of gravity. 

Medications to Strengthen Bones

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Certain medications can also reduce the risk of fractures due to osteoporosis, Dr. Venkatarayappa said. 

Bisphosphonates, the most common type of bone-strengthening medications, can be started in patients who have been diagnosed with osteopenia, a condition in which bone mass is low, but not yet as low as osteoporosis.

These medications can be taken orally once a week or once a month or by injection once a year. Due to their cost these medications offer the greatest payoff for patients who are at high risk of fractures. 

Treating Osteoporosis Fractures

Osteoporosis-related fractures are treated differently than typical fractures. A technique called locked plate fixation, using a steel plate and screws, stabilizes the fracture for healing. 

Dr. Venkatarayappa explains that calcium phosphate is injected into the fractured osteoporotic bone “to increase the density of the bone, so the screws will gain a firmer hold while the fracture heals.” The calcium phosphate lasts in the body for atleast three months, until the bone heals and is replaced by new bone, he said.