Home / Conditions / Osteoporosis
Bone that has thinned enough to break from a minor fall or strain. It causes no symptoms until something breaks — which is why a bone density scan, and treating the bone after a first fracture, matter so much.
Bone is living tissue, constantly broken down and rebuilt. Up to about the age of 30 the rebuilding wins, and bone becomes denser. After that the balance slowly tips the other way. When the loss outpaces the rebuilding enough, the internal structure of the bone thins and its struts break down, and the bone fractures under loads it used to take.
Bone loss speeds up in women for several years after menopause, when oestrogen falls. Men lose bone too, more gradually, and around one in five men over 50 will have a fracture because of it — alongside about one in three women.
There are no early symptoms. Osteoporosis does not cause aches, and it is not detected by receding gums, brittle nails or a weaker grip. Most people learn they have it when a bone breaks, or when a scan is done for another reason.
A bone density scan gives a T-score: how your bone density compares with a healthy young adult. It sets the label, but not the whole decision.
| Normal | Osteopenia | Osteoporosis | |
|---|---|---|---|
| T-score | −1.0 or above | Between −1.0 and −2.5 | −2.5 or below |
| What it means | Bone density in the usual range | Thinner than usual, but not osteoporosis | Bone thin enough that fractures happen easily |
| Usually next | Calcium, vitamin D, exercise; rescan if risks change | The same, plus a fracture risk estimate; medicine for some | Medicine to strengthen bone, alongside the above |
A broken bone changes the answer. A fracture of the hip or spine after a minor fall or strain means the bone is already failing, and treatment is usually recommended whatever the T-score says.
Call us on +65 8849 0677. We will see you the same day and arrange imaging if it is needed.
A fracture like this is often the first sign of osteoporosis, and it is the moment when treating the bone does the most good.
Call +65 8849 0677Who should be scanned? Women from around 65 and men from around 70; earlier for anyone who has broken a bone in a minor fall, takes long-term steroids, has had an early menopause, or has another risk factor above.
Treatment has two aims: making bone stronger, and making a fall less likely. Both matter, because most fractures need the two things together — weak bone and a fall.
Calcium from food where possible: dairy, tofu set with calcium, sardines with bones, leafy greens. Vitamin D is low in many people in Singapore despite the sunshine, since much of the day is spent indoors; a supplement is often needed, and a blood test shows whether.
Weight-bearing exercise such as brisk walking or stair climbing, plus resistance work two or three times a week. Balance training, such as tai chi, reduces falls. Swimming and cycling are good for fitness but do little for bone.
Reviewing medicines that cause drowsiness or dizziness, checking eyesight, removing loose rugs and clutter, lighting the route to the bathroom, and using grab bars where useful.
Recommended for osteoporosis on a scan, and usually after a fragility fracture of the hip or spine whatever the scan shows.
Treatment is reviewed after three to five years, and a dental check before starting is sensible, since jaw problems are a rare side effect of these medicines.
Broken wrists, hips and vertebrae are treated on their own terms — see spinal compression fracture — with the underlying bone treated at the same time.
Not in itself. The pain comes from fractures. A spinal compression fracture can cause sudden back pain, and several of them can cause a lasting stoop and ache.
No. Osteopenia means bone density is below average but not low enough to be called osteoporosis. Many people with osteopenia need no medicine, though some do, depending on their overall fracture risk.
Weight-bearing and resistance exercise helps maintain bone and improves strength and balance, which prevents falls. On its own it rarely reverses osteoporosis, so it is used alongside treatment rather than instead of it.
Usually several years, then a review. Some people pause bisphosphonates after three to five years; denosumab is different and should not be stopped without another treatment in place.
Yes. Bone loss is slower in men and starts later, but around one in five men over 50 has a fracture because of it. Long-term steroids, low testosterone and heavy alcohol use raise the risk.
No. Bring any previous bone density results, X-ray reports, and a list of your medicines, especially steroids.
Spinal compression fracture · Kyphosis · Scoliosis · Back pain · Hip pain · Wrist pain
If you have broken a bone in a minor fall, mention it when you book. That one fact changes what gets checked.
