Common Questions


How do I know if I need a ‘bone check’?

If you have broken a bone easily, especially if you have other significant risk factors for osteoporosis and fragility fractures, then it may be a sign your bones are fragile and you will benefit from a bone check with your GP. 

What do you mean by ‘risk factors’ for osteoporosis and fractures?

A risk factor is something about you that increases the likelihood of developing a disease or injury.  For osteoporosis, it could be your age or gender; an aspect of your lifestyle such as smoking or drinking excessive amounts of alcohol or some medical conditions such as rheumatoid arthritis or medicines like corticosteroids. .

Find out more about risks – download our leaflet

A nurse at the hospital talked to me about my osteoporosis and fracture risk when I broke a bone - should I ask for a bone check?

It sounds as though you have seen a specialist health professional who will have given you a bone check and will have referred you through to a doctor for more detailed investigations, assessment and medical advice if necessary. You may also have been referred to ‘falls prevention services’ if you are falling frequently or to other services within the hospital or social care setting. If you have already had this help then you don’t need to ask your doctor for another bone check.

What does the bone check involve? 

First of all, it’s about having a discussion with your GP or another health professional involved in your care who can gather all the information about your broken bone (fracture) to decide if it is likely to be the result of osteoporosis.  During your appointment your doctor will consider what other risk factors you have and whether you need more detailed tests to find out how fragile your bones are.  Your doctor may use a specific ‘risk factor assessment tool’ to put together all your risk factors and calculate  your risk your risk of breaking another bone in the next 10 years.

What is the ‘bone check' checking for?

A bone check is to find out if you are likely to have fragile bones and whether you at risk of breaking more bones in the future. 

Why is it important to know? 

A range of drug treatments are available for those at high risk of a fragility fracture to prevent further fractures in the future.  A bone check is a good starting point to make sure you are given a drug treatment if you need one.

If bones break very easily will osteoporosis always be the cause?

No, there are other conditions which may need investigating and treating which is why an overall ‘bone check’ is the best first approach. 

Does a bone check mean having a DXA bone density scan?

No, not always. The ‘check’ is the first discussion with your doctor and an assessment of all the risk factors you have.  You may be referred for a bone density scan if there is uncertainty about whether your bones are fragile. Usually you will be referred for a scan before a decision is made to prescribe a drug treatment to strengthen your bones.

A bone density scan may not be appropriate for you. Your doctor may suggest other investigations or tests or, after discussion with you, may decide your fracture was simply the result of an accident and that further tests or treatments are unnecessary.

For more information about scans and tests including bone density scanning - download our leaflet

I am already taking osteoporosis drugs – do I need a bone check?

A bone check is a starting point to encourage those who haven’t been checked out to have discussions with their doctor or an appropriate health professional about their bone health.  So if you are already on a drug treatment you will already have had a discussion with your doctor who has prescribed a drug because you are at high risk of breaking a bone. A ‘bone check’ will not therefore be applicable to you.  Having said that, it is always useful to have your treatment reviewed after a number of years to make sure you still need it

What help is available if I have osteoporosis and fragile bones?

There are a range of drug treatments available which strengthen your bones and reduce your risk of having another fracture. These will usually be prescribed if your risk of a future fracture is high.

Even If you don’t need a drug treatment now, your doctor may decide to monitor you and call you back in again in the future to make sure your situation hasn’t changed.  Sometimes, but not always, you will be referred for a bone density scan at this point. If you are having repeat falls in older age then you may need further investigations or referral to a specialist falls clinic for help and advice.

The charity has lots of information to help you make lifestyle changes to help build and maintain strong bones - read about healthy living on our website.

How do I get a bone check?

If you didn’t have a discussion about your risks of osteoporosis and fragility fractures at the hospital, after you had the fracture, then make an appointment at your local GPs practice. If you explain you have broken a bone very easily and want to discuss whether you might have osteoporosis and fragile bones then your doctor will discuss this with you and decide whether you need further tests, investigations or treatments.

I'm 79 - am I too old to get the bone check? 

It’s never too late – the older you are then the greater chance you will have osteoporosis.

However the main point of a bone check with your doctor is to highlight who might need further investigations and drug treatments.  Everyone needs to be treated as an individual and occasionally if someone is frail and unwell their doctor may feel bone investigations or osteoporosis drugs are inappropriate. A proper discussion and explanation would always be important.

My mother's GP hasn't offered her a bone check even though she's broken her hip recently - what can we do?

If your mother had no discussion about osteoporosis after she broke her hip and isn’t taking a drug treatment for osteoporosis then encourage her to talk to her doctor. You, or your mother, are very welcome to contact the charity helpline if you would like to talk things through with one of our osteoporosis nurses.

I don't want to waste my GP's time, how do I know if I really need a bone check?

If you have broken a bone easily, perhaps after a simple fall, then it would be sensible to discuss this with your doctor. Obviously, anyone might break bones in some situations, like a car accident or falling downstairs so these fractures would not count.  The most common sites for fragility fractures are the hip, the wrist and the spine – but any bone could be linked to osteoporosis apart from fingers, toes and the skull.

Will my GP know what I am talking about?

GPs know about the link between broken bones and osteoporosis. In fact a small amount of funding is paid to a GP practice when a GP carries out a bone check in anyone over the age of 50 who has broken a bone.  This payment is made through the ‘Quality and Outcomes Framework’ (QOF) which rewards good practice

What could be the outcome of the bone check?

If you appear to have no risk factors for osteoporosis and fragile bones and the ‘fracture risk assessment’ shows you are at a low risk of further fractures then your doctor may simply advise you to consider lifestyle changes to maintain strong bones - read more on our website.  If you are at high risk of future fractures, your doctor will prescribe a drug treatment to reduce your fracture risk. However before a drug treatment is prescribed you may need, or be referred to the hospital for, further tests or scans to help understand if you have other medical conditions that could reduce your bone strength. If you are on a medicine for another condition that causes osteoporosis then an alternative drug might be considered.


ABOUT RISKS FOR OSTEOPOROSIS AND FRACTURES

My mother had osteoporosis - should I go to my doctor?

If you have broken a bone easily and have other risk factors, such as a family history, then a discussion with your doctor would be useful to see if you are at high risk of further fractures and need a drug treatment. Our genes are significant in determining our risk of osteoporosis and research has shown that if one of your parents has had a hip fracture, then your own risk of future fractures is increased.

I'm 42 and broke my wrist falling over and I have osteoporosis in my family so I'm worried - what should I do?

If anyone breaks bones very easily then a discussion with the doctor would be useful just to make sure there is no underlying condition that might be affecting bone strength and need managing and treating.

However fragile bones and fragility fractures are much more common in later life when not only do you ‘lose bone density’ but the quality and overall strength of your bones is likely to be reduced. This is why the ‘Stop at One’ campaign is focusing on people over 50. 


ABOUT YOUR BROKEN BONE

I broke a bone when I was a child - should I worry?

No, fractures are very common in children but they aren’t fragility fractures and are not caused by osteoporosis. There is a very rare type of juvenile osteoporosis and sometimes children get osteoporosis as a result of other medical conditions or medicines but this is unrelated to the generalised osteoporosis and fractures that affects older people.  If, however, you have a child yourself who was breaking bones very easily it would be useful to discuss this with your GP.

I broke a bone 10 years ago - is it still worth having the bone check?

If you broke a bone very easily and especially if you have other risk factors then a discussion with your doctor would be useful.  If you want to discuss your situation first you are welcome to contact our helpline and speak to one of the charity’s osteoporosis nurses.

I broke bones in a car accident last year – wouldn’t that happen to anyone? 

Yes. Fractures that may indicate your bones are fragile, called fragility fractures, are bones that break after mild trauma such as a fall from a standing height or less . 


HEALTHY LIVING FOR STRONG BONES

Can I change my diet to help me guard against osteoporosis?

A well balanced calcium rich diet is essential to provide all the vitamins, minerals and other nutrients that your bones need. Although a healthy lifestyle doesn’t guarantee you won’t have osteoporosis and fragile bones, it will help reduce the risk of fragility fractures as you age.

I'm too afraid to do any exercise now I have osteoporosis - what can I do?

Exercise is important to build and maintain strong bones even if you have osteoporosis and fragile bones.  In older age, keeping active and maintaining muscle strength, balance and coordination will reduce your risk of falling. If you have broken bones easily, especially if you have compression fractures in your spine, you may need to be careful about vigorous, high impact exercise and forward bending. (touching your toes)

There is lots more information in our exercise leaflet.

I already exercise and eat well, I'm sure there's nothing else I can do to protect myself - am I missing anything?

Avoid excessive amounts of alcohol and don’t smoke.  Make sure you have sensible exposure to sunlight to get sufficient vitamin D. Some people might benefit for vitamin D supplements. Aim for a healthy body weight to help protect your bones.  Find out more about osteoporosis; how to avoid and manage risks and live healthily and reduce the risk of fragility fractures into older age. Read about healthy bones on our website.