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Diseases & conditions
Bones & joints

Osteoporosis

Osteoporosis is a condition in which the bones become thin and weak, so they break easily, even after a small fall. It is most common in women after menopause and in older men. It causes no symptoms until a bone breaks, often the wrist, hip or spine. In Afghanistan, low vitamin D from little sunlight, low calcium in the diet and many pregnancies add to the risk.

Symptoms

  • Usually no symptoms until a bone breaks
  • A broken wrist, hip or spine after a minor fall
  • Sudden back pain from a collapsed spine bone
  • Loss of height over time
  • A stooped, bent-forward back

When to see a doctor

Get medical help quickly if you notice any of these:

  • A fall followed by pain and inability to stand or walk: go to hospital now
  • Sudden severe back pain, especially in an older person
  • A bone that broke after a minor fall
  • Loss of height or a curving back
  • You take long-term steroids, had an early menopause, or have a family history of hip fracture

In an emergency, go to the nearest hospital or clinic straight away.

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Causes

  • Menopause (loss of the hormone oestrogen) and older age
  • Low calcium in the diet and low vitamin D (little sunlight on the skin)
  • Low body weight and poor nutrition
  • Long-term use of steroid tablets
  • Smoking and lack of physical activity
  • Family history, an overactive thyroid and some other medical conditions

Prevention

  • Eat calcium-rich foods every day: milk, yoghurt, dogh, cheese, beans and green leafy vegetables
  • Get some safe sunlight on the face and arms, or take vitamin D if a doctor advises
  • Walk and do weight-bearing exercise regularly
  • Do not smoke
  • Prevent falls at home: good lighting, no slippery rugs, a handrail on stairs
  • Women over 65 and people with risk factors can ask about a bone density test

Treatment

  • Calcium and vitamin D supplements if your diet is low in them, as advised by a doctor
  • Bone-strengthening medicines such as alendronic acid, prescribed by a doctor
  • Exercise to improve strength and balance
  • Fall prevention at home
  • Treatment of the underlying cause where possible
  • Do not take steroid tablets or injections without a doctor

Common questions

Can young women get weak bones too?

Yes. A poor diet, little sunlight, many pregnancies close together and long breastfeeding without enough calcium and vitamin D can weaken the bones of younger women. A good diet and safe sunlight protect the bones for life.

How should alendronic acid be taken?

Usually once a week, first thing in the morning on an empty stomach, with a full glass of plain water, staying upright for at least 30 minutes before eating. Follow your doctor's instructions exactly.

General information onlyThis guide does not replace an examination by a doctor. Do not start or stop a medicine without a doctor's advice.