How would I know if I have osteoporosis? I feel fine.
That’s the disease’s signature — no symptoms until a fracture. The clues that warrant screening: a fracture from a minor fall after 50, losing more than 3-4 cm of height, a rounding upper back, long steroid use, early menopause, or a parent’s hip fracture. Screening is a painless DEXA scan.
What is a DEXA scan and what do the numbers mean?
A low-radiation scan measuring bone density at the hip and spine. Your T-score compares you to healthy young adults: above −1 is normal, −1 to −2.5 is osteopenia (low bone mass), −2.5 or below is osteoporosis. Risk calculators like FRAX combine this with your history to estimate 10-year fracture probability — which is what actually guides treatment decisions.
Can exercise really rebuild bone?
The right exercise, yes — modestly in density, powerfully in fracture-relevant strength. Bone adapts to meaningful load: progressive resistance training and impact loading. The landmark LIFTMOR randomised trial (Watson et al., 2018) showed supervised heavy lifting improved spine and hip density in women with low bone mass — safely. Gentle walking alone, honestly, isn’t enough of a signal; swimming and cycling, whatever their other virtues, barely speak to bone at all.
Isn’t heavy lifting dangerous with fragile bones?
Unsupervised and unprogressed, it could be — which is why the trial evidence matters: properly coached, progressively built resistance training produced no fractures in osteoporotic participants while strengthening bone and posture. Supervision and progression are the safety mechanism, and they’re exactly what our programme provides.
Do I really need medication, or can I manage naturally?
Depends on your measured risk — honestly. For high fracture risk (prior fragility fracture, very low T-scores, high FRAX), bone medications reduce new fractures by 30-60% in trials; declining them costs real fractures. For milder low bone mass, exercise, nutrition and risk-factor work may be the appropriate whole plan. We give you the honest risk arithmetic and coordinate the medication decision with your physician.
How much calcium and vitamin D do I need?
Roughly 1000-1200 mg calcium daily — food first (dairy, ragi, sesame, small fish, greens), supplementing only the gap — plus vitamin D sufficiency (commonly 800-1000 IU daily; deficiency is widespread even in sunny Kerala) and often-forgotten protein: about 1-1.2 g/kg daily, since muscle protects bone and prevents falls.
What matters more — stronger bones or not falling?
Both, but falls are the trigger: most hip and wrist fractures start with one. Balance training (including tai-chi-style and yoga-based work), home hazard fixes, vision checks and medication reviews cut falls measurably — the fastest fracture prevention available. Our programme trains balance alongside bone loading.
When is surgery indicated for osteoporosis?
For the fractures, not the disease: broken hips need prompt surgical fixation or replacement (within 48 hours where possible — outcomes depend on it), and some wrist fractures need fixation. Painful vertebral fractures are mostly managed conservatively; cement procedures (vertebroplasty/kyphoplasty) remain debated — trials are mixed — and are reserved for selected persistent cases. After ANY fragility fracture, the most important ‘procedure’ is starting real osteoporosis treatment so the next fracture never happens — the step healthcare most often misses.
Can osteoporosis be reversed?
Realistically: substantially improved, seldom fully reversed. Medication plus loading exercise typically stabilises or raises density a few percent — but fracture risk falls far more than density numbers suggest, because strength, balance and bone quality improve together. The goal is honest and achievable: a fracture-free future, not a perfect scan.
