Osteoporosis: The Silent Bone-Thinning Disease and Who Needs a DEXA Scan

If you have picked up this article because a parent broke a hip after a small slip, or because your own back seems to be curving a little more each year, I understand the worry. In my clinic in Viman Nagar I meet many people who had no idea anything was wrong with their bones until something cracked. That is the difficult part of osteoporosis. It gives almost no warning.

The good news is that osteoporosis can be picked up before it causes harm, and there is a lot you can do once you know where you stand. Let me explain it in plain terms, so you can decide whether a bone density test is worth talking to a doctor about.

What osteoporosis actually is

Your bones are living tissue. All through life the body removes a little old bone and lays down a little new bone. In younger years the building keeps pace with the removal. As you get older, and especially after menopause in women, the removal starts to win. Bit by bit the bone becomes less dense and more porous on the inside. That is what osteoporosis means, bone that has grown thin and fragile.

Here is the part that catches people out. This thinning does not hurt. There is no ache that tells you it is happening. Many people feel completely fine and stay active right up to the day a bone gives way. Often the very first sign is a fracture from something that should not break a healthy bone, a minor fall in the bathroom, a stumble getting off an auto, or even a hard sneeze or bending to lift a bag.

Common warning situations

• A broken wrist, hip or shoulder after a fall from standing height, not a big accident.
• Losing height over the years, a few centimetres shorter than you used to be.
• A back that is slowly rounding forward, sometimes with a nagging upper back ache.
• A sudden sharp pain in the back with no obvious cause, which can be a small spine fracture.

None of these prove osteoporosis on their own, but any of them is a good reason to get your bones checked rather than shrug it off as ordinary ageing.

Who is more at risk

Osteoporosis is more common than most people think, and some things make it more likely. You cannot change some of these, but knowing them helps you and your doctor decide when to look closer.

• Age. Risk climbs steadily as the years add up, for both men and women.
• Menopause. Women lose bone faster in the years after periods stop, because of the drop in oestrogen. An early menopause raises the risk further.
• Low calcium and low vitamin D over many years, which is very common in our city despite all the sunshine, because so much of the day is spent indoors.
• Long term steroid medicines, for example for asthma, arthritis or certain other conditions.
• Smoking and heavy alcohol use.
• A family history of osteoporosis or of a parent breaking a hip.
• A slim, small build.
• A sedentary life with very little weight-bearing activity.
• Some thyroid, hormone and digestive conditions, and some other long term illnesses.

What a bone density (DEXA) test does

A DEXA scan is a simple, painless way to measure how dense your bones are, usually at the hip and the lower spine. You lie on a table for a few minutes while the scanner passes over you. There are no injections and no need to stay overnight. The result tells the doctor whether your bone density is normal, slightly low, or in the osteoporosis range, and that guides what happens next.

You do not need this test at random. It is arranged where it is genuinely indicated, after a doctor has heard your history and examined you. As a general guide, it is worth discussing a bone density test if any of the following fit you.

• Women around and after menopause, particularly with any of the risk factors above.
• Men and women in the older age group, especially past the age when bone loss speeds up.
• Anyone who has broken a bone from a minor fall or knock in adult life.
• People on long term steroid medicines.
• Anyone who has clearly lost height or whose upper back is rounding.
• People with a strong family history or a medical condition that affects the bones.

If that sounds like you, please do not order tests for yourself. Sit with a doctor first. The right test at the right time is far more useful than a scan done without a reason.

What helps your bones

I want to be honest with you. Osteoporosis is managed, not fixed overnight. Bone rebuilds slowly, so this is steady work rather than a quick repair. But the steps that help are very much within reach, and they help at any age.

• Get enough calcium from food, things like milk, curd, paneer, ragi, sesame, green leafy vegetables and dal.
• Look after your vitamin D. Some regular safe sun on the arms and face helps, and your doctor can check your level and advise if it is low. Please do not decide supplements on your own.
• Do weight-bearing and muscle activity. Walking, climbing stairs, and simple strength work signal the bones to stay strong. Even a daily walk around the society compound counts.
• Prevent falls at home, since most serious fractures start with a fall. Clear loose mats, light the passage to the bathroom, use a bathroom mat with grip, and fix a rail where the floor gets wet.
• Stop smoking and keep alcohol low.
• Have a medical review, so any medicine you already take and any hormone or thyroid issue is taken into account.

If a scan does show osteoporosis, there are proper treatments a doctor can start. What suits you depends on your reports, your age and your other health matters, so those decisions belong with the treating doctor and not with a chemist counter or a neighbour's advice. Outcomes vary from person to person, and the aim is to protect you from the next fracture.

When to see a doctor

Book a consultation if you fit the risk groups above, if you have lost height, if your back is rounding or aching, or if you have ever broken a bone from a small fall. It is much better to check the bone before it breaks than after.

One safety note. If someone has a fall and cannot bear weight, has a visibly deformed limb, or has severe sudden back pain with numbness, weakness in the legs or loss of bladder or bowel control, treat that as an emergency. Call 108 or go straight to the nearest emergency hospital.

Where to get checked in Pune

At Prudent International Health Clinic in Viman Nagar, I see patients for bone and joint concerns like these. I am Dr. Girishchandra Bartakke, an orthopaedic surgeon with thirty five years in practice. In our consultation I will listen to your history, examine you, and where it is indicated a bone density (DEXA) scan is arranged for you, with the reports reviewed together and a plan made for your care. If treatment or, rarely, surgery is ever needed, evaluation and follow-up happen at our Viman Nagar clinic and any operation is arranged with our accredited partner hospitals.

We are an outpatient multi-specialty clinic at DNK Square, Office No. 503, 5th Floor, New Airport Road, Sakore Nagar, Viman Nagar, Pune 411014, open all 7 days from 9 AM to 9 PM with no lunch-hour closure, and walk-ins are welcome. To book or to ask about current pricing, call or WhatsApp us on +91 70287 22200. Your bones do their work quietly for a lifetime, so let us make sure they stay strong.