How can a 67-year-old woman check for weakened bones?

Question

Hello doctor,

I am a 67-year-old woman who recently broke my wrist from a minor fall. It has caused such serious injury, and my doctor is concerned about my bone density. I have been experiencing persistent back pain and have noticed that I am getting shorter.

My clothes fit differently, and I cannot reach things I used to reach easily. My posture has become hunched forward, and I have had two compression fractures in my spine over the past year from activities as simple as lifting groceries.

I went through menopause 15 years ago and have a family history of fractures in elderly women. I have never been very active and have taken calcium supplements. My recent bone scan showed concerning results, and I am worried about breaking more bones from everyday activities.

Could my frequent fractures, height loss, and back pain all be signs that my bones have become dangerously weak and brittle?

Please suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

From what you describe, repeated fractures after minor falls, compression fractures in the spine, loss of height, hunched posture, persistent back pain, and a family history of fractures are strong indicators of osteoporosis, a condition where bones become weak and brittle due to reduced bone density. This is quite common in women after menopause, especially if there has not been regular calcium or vitamin D intake or weight-bearing exercise.

The fact that your recent bone scan was concerning further supports this possibility. Your bones are indeed at a higher risk of breaking even with simple daily activities. Osteoporosis can explain your wrist fracture, spine fractures, loss of height, and change in posture.

Your symptoms are very typical of osteoporosis, but proper treatment can significantly reduce future fracture risk and improve quality of life. Please do not ignore this. The earlier the treatment is started, the better the bone protection.

X-rays of the spine and affected bones should be taken to look for compression fractures.
A bone mineral density (BMD) or DEXA (dual energy X-ray absorptiometry) scan is also recommended. It is the gold standard for diagnosing osteoporosis and assessing its severity.
Do blood tests such as serum calcium, phosphate, alkaline phosphatase, 25-hydroxyvitamin D, parathyroid hormone (PTH), thyroid function tests (TSH (thyroid-stimulating hormone), T4 (thyroxine)), renal function tests, liver function tests, CBC (complete blood count) and ESR (erythrocyte sedimentation rate) to look for anemia or inflammation and rule out malignancy if needed.
Do a 24-hour urinary calcium if secondary causes are suspected.

Consult your doctor, an endocrinologist, or an orthopedic specialist to discuss starting specific osteoporosis treatment (such as bisphosphonates, Denosumab, or newer therapies depending on your scan and medical history). Ensure adequate calcium and vitamin D supplementation as advised by your doctor.

Do lifestyle changes such as gentle weight-bearing exercise, fall prevention at home, and avoiding smoking or alcohol. Pain and posture can improve with physiotherapy and back-strengthening exercises under supervision. Regular follow-up and bone density scans are important to monitor progress. Have a follow-up soon.

I hope this answers your query.

Let me know if I need to assist you further.

Thank you.