MANY medical conditions are silent until a fairly serious event. Osteoporosis, also known as thinning of the bones, falls into this category. Currently, there are an estimated three million people in the UK with osteoporosis, with half a million fractures every year as a result.

Unfortunately, thinning of the bones is part of the natural ageing process. Until we reach 35, bone formation is greater than its loss, but after this point the reverse becomes the case. The menopause causes a fall in the levels of oestrogen, and this goes some way to explaining the increased numbers of women with the osteoporosis after 50.

However men also get the disease, and the menopause cannot be solely blamed. Exercise stimulates bone growth and indeed strength, so immobility is one of the biggest risk factors.

Being underweight is another problem, and the disease is common in those with anorexia. Treatment with steroids for more than three months thins the bones, and we know that the lifestyle choices of smoking and excess alcohol also play their part.

Both calcium and vitamin D are needed for good bone strength, so if your diet is low in these, you may also be at risk.

As mentioned previously, osteoporosis doesn’t cause pain on its own, so often the first time you become aware of it is when a bone fractures.

Typically this is either in the wrist or hip, and usually follows a minor tumble which would be of no consequence to a healthy individual.

Equally a relatively gentle sneeze might cause a rib fracture. Curving of the spine results from collapse of several bones in the spine, resulting in problems with breathing, as the rib cage is less able to expand.

Unfortunately fractures often result in a loss of confidence and for some, severe pain and disability, so identification and prevention really are the key.

Scoring systems are available and will help your routine GP in calculating your chance of a sustaining a broken bone. If your score is high enough, you may be referred for a scan, which assesses the strength of your bones by measuring bone mineral density in the hip and spine.

Osteopenia is the stage before osteoporosis, and although not severe, many of the treatments and lifestyle modifications will still help.

TREATMENT for both osteopaenia and osteoporosis starts with ensuring that you have adequate calcium and vitamin D in your diet. It is now recommended to take a daily vitamin D supplement, but your requirement for calcium should be met by a pint of milk or fifty grams of hard cheese.

The most commonly used drugs for established osteoporosis are called bisphosphonates, usually prescribed as a once weekly tablet.

Preventing falls in the first place should not be ignored. Regular weight bearing exercise will not only strengthen bones but improve your balance.

Both sight and hearing are important to spatial awareness, so please attend for routine checks.

Finally, decluttering your house will mean less potential obstacles for you to trip over.