Patient information from BMJ

Osteoporosis

Last published:Mar 12, 2025

Osteoporosis is a condition that weakens your bones, making them fragile and more likely to break. It’s more common in older women, especially after the menopause. Osteoporosis develops slowly and usually has no signs at first. Many people do not know they have it until they break a bone.

This information helps explain what osteoporosis is, what the symptoms are, and how it’s diagnosed.

What is osteoporosis?

Osteoporosis is a condition that makes your bones weak and fragile. This means they can break (fracture) easily, even from a small fall or bump.

Throughout your life, your bones are constantly being renewed as your body forms new bone cells and breaks down old ones. When you’re young, your body makes new bone faster than it breaks down old bone, so your bones become stronger. But as you age, old bone is broken down faster than new bone is made, which makes your bones weaker.

This is a normal part of aging. However, osteoporosis happens when people lose bone faster than normal. This makes your bones weaker and more likely to fracture.

Osteoporosis is more common in women than men, especially after the menopause. This is because the hormone changes after the menopause speed up bone loss.

Osteoporosis is also more common in people who take steroid tablets for other conditions. 

What are the symptoms of osteoporosis? 

The main symptoms of osteoporosis are:

• Bone fractures: Having osteoporosis means you have weaker bones that fracture more easily. You may not know you have osteoporosis until you break a bone. The spine, hip and wrist are the most common bones that break.

• Back pain: This can be caused by small fractures in the vertebrae (the bones in the spine). You may not realise that your back pain is caused by fractures.

• Hunched posture: Osteoporosis can cause your spine to curve, leading to a hunched back (called kyphosis).

Many people break bones without having osteoporosis, usually because of a bad accident. But if you have osteoporosis your bones break more easily. For example, you could break your hip from a simple fall, whereas someone without osteoporosis wouldn't. Or you might fracture your wrist by using your hand to break a fall. Breaking a bone from a minor accident is called a fragility fracture.

How do doctors diagnose osteoporosis?

Most of the time, your doctor will be able to tell that you have osteoporosis just by asking you a few questions and examining you. To be certain, they will likely refer you for a DXA scan.

A DXA scan is a type of bone scan that checks how strong your bones are. It’s quick and painless. You lie on a table while a machine takes pictures of your bones, usually in your hip and spine.

Doctors compare your bone strength to that of young, healthy adults. The difference between your bone strength and theirs is called a T-score. This score helps doctors understand how weak your bones are. The lower the T-score, the weaker your bones are.

• A T-score of 1 to -1 means your bones are normal.

• A T-score of -1 to -2.5 means your bones are weaker than normal. This is called osteopenia.

• A T-score below -2.5 means you have osteoporosis.

• A T-score below -2.5, plus a past fragility fracture, means you have severe osteoporosis.

If you have osteoporosis or osteopenia, you’ll likely have a DXA scan every few years so doctors can check up on your bone strength.

What happens next?

If you have osteoporosis, you might worry about what this means for your future. While it's true that your risk of fractures is higher, it doesn't mean they will definitely happen. But it’s very important to do what you can to prevent fractures. It takes a longer time to recover from a broken bone the older you get. 

Taking steps to prevent falls, eating well, taking the right supplements, and getting the right treatments from your doctor can reduce your chance of breaking a bone. You can find more detail on how to prevent fractures in our patient information titled: Osteoporosis: what are the treatment options?

Where to get more help

There are charities and support groups for people with osteoporosis and their families. Your doctor may be able to help you find one in your area, or you could search online. These groups often have useful resources and services and can connect you with others who are going through a similar experience.