Osteoporosis Q&As
Published by Bupa's health information team, February 2009.
Answers to questions about osteoporosis
This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
- I think I may be at risk of osteoporosis. Should I have a bone scan?
- How much calcium should I be getting to help prevent osteoporosis?
- I can't eat dairy food. How do I make sure I get enough calcium?
- My doctor has told me to eat a low-fat diet. How can I get enough calcium if I have to limit cheese and milk?
- I have osteoporosis. How do I deal with the pain from broken bones?
I think I may be at risk of osteoporosis. Should I have a bone scan?
Talk to your doctor about what is best for you.
Explanation
Many people don't know that they have osteoporosis until they break a bone - often a hip, wrist or bones in the spine. However it's possible to find out if you have osteoporosis before you have a break using bone density scanning. DEXA scanning (dual X-ray absorptiometry) is the most effective way of diagnosing osteoporosis. Other techniques have been used but they haven't been shown to be as reliable as DEXA scanning.
DEXA scanning is expensive and its availability may be limited. Doctors make the decision about who to scan based on each patient's level of risk and the availability of DEXA scanning in the particular area. In July 2006 the National Screening Committee looked at whether routine screening for osteoporosis should be made available. The Committee concluded that at present this type of screening shouldn't be introduced. The National Institute for Health and Clinical Excellence (NICE) is now looking into this.
If you are concerned that you are at risk of osteoporosis, talk to your doctor.
Further information
- National Osteoporosis Society
www.nos.org.uk
Sources
- Management of osteoporosis. Scottish Intercollegiate Guidelines Network (SIGN), June 2003. www.sign.ac.uk
- Clinical guidelines for prevention and treatment. Royal College of Physicians, 5 January 2001. www.rcplondon.ac.uk
- Osteoporosis. National Institute for Health and Clinical Excellence (NICE), accessed 16 January 2008. www.nice.org.uk
- National Screening Committee policy. NHS Library for Health. www.library.nhs.uk, accessed 16 January 2008
- Bone density scanning. National Osteoporosis Society, December 2005. www.nos.org.uk
How much calcium should I be getting to help prevent osteoporosis?
This depends on your age and, if you are a woman, whether you have been through the menopause.
Explanation
If you think you may be at risk of developing osteoporosis, talk to your GP. If you are a woman who hasn't been through the menopause, try to get 700mg of calcium per day. This is the daily amount of calcium recommended for the majority of adults by the Food Standards Agency. It should be possible to get 700mg of calcium a day from your diet. If you find this difficult you may need to take a calcium supplement.
Once you reach the menopause you are recommended to increase the calcium in your diet to 1,000mg a day. This increased level also applies to people diagnosed with osteoporosis. If you are diagnosed with osteoporosis you may be given a calcium supplement along with your osteoporosis medication.
To give you some idea about how to get enough calcium in your diet, here is the amount of calcium in some everyday foods:
- a 200ml glass of milk contains 240mg calcium
- a 125g plain yogurt contains 250mg calcium
- a 125g fruit yogurt contains 170mg calcium
- 30g hard cheese (like Cheddar or Edam) contains 225mg calcium
- 200g Macaroni cheese contains 340mg calcium
- four slices of white bread contain 200mg calcium
- four slices wholemeal bread contains 120mg calcium
- 60g tinned sardines (in oil) contains 300mg calcium
- 60g tinned salmon contains 50mg calcium
- 150g baked beans contains 80mg calcium
- a 200ml glass orange juice (unsweetened, concentrated) contains 70mg calcium
Your body also needs other nutrients to help you absorb calcium, in particular vitamin D. If you are active, and you are under 65, there is no evidence that you need to take a vitamin D supplement. You may not get enough vitamin D if you are a woman of Asian origin, if you always cover your skin when you are outdoors, if you don't often go outdoors or if you don't eat meat or oily fish. If you don't think you are getting enough vitamin D, you can take a supplement of around 10 micrograms a day.
Further information
- Food Standards Agency
www.food.gov.uk - National Osteoporosis Society
www.nos.org.uk
Sources
- Calcium-rich foods and bone health. National Osteoporosis Society, December 2005. www.nos.org.uk
- Calcium. Food Standards Agency. www.eatwell.gov.uk, accessed 16 January 2008
- Management of osteoporosis. Scottish Intercollegiate Guidelines Network (SIGN). June 2003. www.sign.ac.uk
I can't eat dairy food. How do I make sure I get enough calcium?
It should still be possible to get enough calcium.
Explanation
Even if you don't eat milk or dairy food there are other options. Good sources of calcium include canned sardines, soya beans and tofu, bread, pulses, green vegetables, dried fruit (especially figs), nuts and seeds (particularly almonds and sesame seeds). If you use soya, rice or oat milk, choose one with added calcium.
If you are concerned about how much calcium you are getting, talk to your GP.
Further information
- Food Standards Agency
www.food.gov.uk - National Osteoporosis Society
www.nos.org.uk
Sources
- Milk and dairy. Food Standards Agency. www.eatwell.gov.uk, accessed 16 January 2008
My doctor has told me to eat a low-fat diet. How can I get enough calcium if I have to limit cheese and milk?
There are many low-fat dairy products available. It's best to get some dairy foods each day as they are good sources of calcium.
Explanation
You can either try switching to lower fat options or try using a little less of high-fat foods such as hard cheese. Try switching from:
- whole milk to semi-skimmed or skimmed milk
- Cheddar or Edam cheese to cottage cheese
- cream to yogurt or low-fat crème fraîche in cooking or with desserts
- butter to low-fat spread
Further information
- Food Standards Agency
www.food.gov.uk
Sources
- Milk and dairy. Food Standards Agency. www.eatwell.gov.uk, accessed 16 January 2008
I have osteoporosis. How do I deal with the pain from broken bones?
Talk to your GP. It's important to explore all the options until you find something that helps you.
Explanation
When bones break you will feel immediate pain that can last while the bone and surrounding tissue heals. Everyone's experience of fractures is different. However, vertebral (spine) fractures in particular can cause severe pain. If you go into hospital after a break, your doctors will try and get the best possible pain relief for you.
You can also have longer-term, chronic pain, beyond the usual healing time. This can be caused by your posture having changed due to the fracture. This causes strain on your surrounding ligaments and muscles. Ongoing pain after a fracture can affect your quality of life.
It's important that your doctor helps you to find an approach that works for you. There are different options available. Your doctor is likely to suggest trying either over-the-counter or stronger prescription painkillers. If these don't give you enough pain relief, talk to your doctor about what else you can try - this may include some the following options.
- Calcitonin is a medicine that is usually prescribed by hospitals rather than by your GP. It has been shown to help acute and chronic pain due to a fracture of the spine.
- Non-medicine options include acupuncture or TENS (transcutaneous electrical nerve stimulation). TENS involves using tiny electrical pulses to block pain. Both acupuncture and TENS can give pain relief for some people and are worth trying.
- Exercises that strengthen the back.
- Hydrotherapy (exercise and physiotherapy treatment based in a pool) or physiotherapy.
- If the pain is severe enough to make you depressed, talk to your doctor about some form of talking (psychological) therapy. Some people may also be offered antidepressant medicines. In low doses, antidepressants can help control nerve pain.
- Your doctor may be able to refer you to a specialist pain clinic.
- Self-management courses can help you to cope with long-term pain. Various organisations run these courses - ask your doctor for information about courses in your area.
Further information
- National Osteoporosis Society
www.nos.org.uk - The British Pain Society
www.britishpainsociety.org
Sources
- Management of osteoporosis. Scottish Intercollegiate Guidelines Network (SIGN), June 2003. www.sign.ac.uk
- Coping after broken bones; living with osteoporosis. National Osteoporosis Society, August 2006. www.nos.org.uk
Related topics
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: February 2009
Osteoporosis factsheet
Visit the osteoporosis health factsheet for more information.
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