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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Partly. A doctor can assess your fracture risk, explain scan results and plan or review treatment by video; the bone density scan, X-rays and injections are in person.
- What it is: a condition that makes bones thinner and more fragile, so they break more easily, most often at the wrist, the hip and the spine.
- How common: about 32 million people in the EU, the UK and Switzerland had osteoporosis in 2019, four times as many women as men.
- Main sign: often none until a bone breaks after a minor fall. Loss of height or a stooped back can mean fractures in the spine.
- Emergency: call 112 or go to an emergency department after a fall if you cannot stand or put weight on a leg, or for sudden severe back pain with numbness or weakness in the legs.
Do not book a video appointment after a fall if you cannot get up or put weight on your leg, or a limb looks deformed, or if you have severe back pain with numbness or weakness in your legs or new problems controlling your bladder or bowels. Call 112 or go to an emergency department.
Can an online doctor treat osteoporosis?
Partly. Osteoporosis is diagnosed with a bone density (DEXA) scan, which is done in person, but much of the rest works by video: the doctor can estimate your fracture risk, tell you whether you need a scan, go through the results, start or review bone-strengthening treatment when it is right for you, and help you prevent falls. X-rays, injections and the tests some treatments need are arranged in person.
How an online consultation helps with osteoporosis
- Your fracture risk estimated: Age, sex, earlier fractures, family history, steroids and other risk factors go into a fracture risk score such as FRAX.
- A scan when it will change the plan: Who needs a DEXA bone density scan, and what the T-score in your results means.
- Treatment explained and reviewed: How bone-strengthening tablets are taken, their side effects, and how long to stay on them.
- Fewer falls, fewer fractures: Exercise, calcium, vitamin D, a safer home, and a check of medicines that make falls more likely.
What the doctor checks in an online osteoporosis consultation
The doctor asks about the warning signs first, then about your bones and your risk factors. The doctor asks about:
- Warning signs: a recent fall with pain on standing, sudden severe back pain, or numbness or weakness in the legs.
- Earlier fractures: any bone broken after a fall from standing height or less, and any loss of height.
- Risk factors: your age, the menopause and when it started, a parent who broke a hip, smoking, alcohol and body weight.
- Medicines: steroid tablets for more than 3 months, anti-oestrogen treatment after breast cancer, and medicines for seizures or reflux.
- Other conditions: rheumatoid arthritis, coeliac disease, inflammatory bowel disease, thyroid problems, kidney or liver disease, or an eating disorder.
- Results you already have: a DEXA scan, blood tests or a fracture risk score.
Before the call, have any scan reports, blood test results and the boxes of the medicines you take to hand.
What is osteoporosis, and how common is it?
Osteoporosis is a condition in which bones lose density and become fragile, so they break more easily. It develops slowly over years. Some bone loss is a normal part of ageing, but some people lose bone much faster, and women lose it quickly in the first few years after the menopause.
It is one of the most common long-term conditions in Europe. In 2019, about 32 million people in the EU, the UK and Switzerland had osteoporosis, 25.5 million of them women, and there were about 4.3 million new fractures caused by fragile bones. Worldwide, 1 in 3 women and 1 in 5 men over 50 will break a bone because of osteoporosis.
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| Fracture | Share of all fragility fractures | What it means |
|---|---|---|
| Hip | 19% | The most serious: up to 20 to 24% of people die within a year, and many lose independence |
| Spine (vertebrae) | 16% | Can happen without a fall, and causes back pain, loss of height and a stooped back |
| Wrist and forearm | 15% | Usually after a fall |
| Other bones | 50% | Including the arm, pelvis and ribs; a rib can break with a cough or sneeze |
Osteopenia: the stage before osteoporosis
Osteopenia means bone density is lower than average for your age, but not low enough to be osteoporosis. It does not always lead to osteoporosis, and whether you need treatment depends on how weak your bones are and on your risk of a fracture.
What are the signs of osteoporosis?
Often there are none. Osteoporosis is usually not painful until a bone breaks, and a broken bone after a minor fall is often the first sign. Signs that bones may already be fragile:
- a bone that breaks after a fall from standing height or less, or a minor bump
- loss of height over time
- a stooped or forward-bent posture
- back pain from a broken or collapsed bone in the spine, which can happen without a fall
- a rib that breaks with a cough or a sneeze
Osteoporosis does not cause pain on its own, but spinal fractures are a common cause of long-term back pain.
Who is at risk of osteoporosis?
Anyone can develop osteoporosis, including men and younger women, but the risk is higher with:
- being a woman, especially after the menopause, and more so if it started before 45 or the ovaries were removed
- older age, and a small body frame
- a parent or sibling with osteoporosis, especially a parent who broke a hip
- steroid tablets taken for more than 3 months
- other medicines that affect bone or hormones, such as anti-oestrogen tablets after breast cancer, treatments that lower hormones in prostate cancer, and some medicines for seizures or reflux
- conditions such as rheumatoid arthritis, coeliac disease, inflammatory bowel disease, an overactive thyroid, kidney or liver disease, and a current or past eating disorder
- a low body weight, little exercise, smoking, and more than two alcoholic drinks a day
Is osteoporosis hereditary?
Partly. A family history raises your risk, especially a parent who broke a hip, and doctors ask about it when they estimate your fracture risk. Your lifestyle, your medicines and other conditions still matter.
How is osteoporosis diagnosed? Bone density scans and T-scores
Doctors first estimate your risk of breaking a bone with an online tool such as FRAX or QFracture, using your age, sex, weight, earlier fractures, family history, medicines and other conditions. If the risk is high enough, a DEXA bone density scan measures how strong your bones are. The scan is short and painless, and takes 10 to 20 minutes.
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| T-score | What it means |
|---|---|
| Above -1 | Normal bone density |
| Between -1 and -2.5 | Osteopenia: bone density lower than average |
| Below -2.5 | Osteoporosis |
The T-score compares your bone density with that of a healthy young adult. Treatment is decided on your overall risk of a fracture, which includes your age, sex and earlier fractures, not on the score alone.
Can you check your bone density at home?
No. Bone density can only be measured with a scan. A doctor can still estimate your fracture risk from your risk factors before any scan, and tell you whether one is worth having.
Can osteoporosis be cured or reversed?
Treatment aims to prevent broken bones. Most bone-strengthening medicines slow the breakdown of bone, which keeps bone density steady and lowers the risk of fractures; parathyroid hormone can increase bone density. Exercise, calcium and vitamin D, not smoking and drinking less help keep bones as strong as possible.
Life expectancy and living with osteoporosis
The main danger is a fracture, especially of the hip. Up to 20 to 24% of people who break a hip die within the first year, and a third are fully dependent or in a care home a year later. In 2019, about 248,000 deaths in the EU, the UK and Switzerland were linked to fractures from fragile bones. A first fracture raises the risk of another by 86%, most in the first 2 years, which is why a fracture after a minor fall should lead to a check of your bones.
In Europe, fewer than half of women at high risk of a fracture are treated. Treatment, exercise and care to avoid falls all lower the risk of the next fracture.
Which osteoporosis treatment might the doctor recommend?
Treatment depends on your fracture risk, your scan results, any earlier fractures and your other conditions. This is the framework the doctors use:
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| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Risk factors, but no fracture or scan yet | A fracture risk estimate, and a DEXA scan if the risk is high enough | Yes | For the scan |
| Osteopenia on a scan | Exercise, calcium and vitamin D, and a review of your fracture risk | Yes | Not usually needed |
| Osteoporosis on a scan, or a fracture after a minor fall | Bone-strengthening treatment, usually a bisphosphonate, after any tests needed | Partly | For blood tests, and injections if needed |
| Already on treatment, with questions or side effects | A review of how you take it, side effects and how long to continue | Yes | If an injection-based treatment is needed |
| An early menopause, or menopause symptoms with bone loss | A discussion of HRT | Yes | Not usually needed |
| Sudden back pain, or a painful bone after a minor fall | An X-ray to check for a fracture | Partly | For the X-ray |
| A fall with a leg you cannot stand on, or numbness or weakness in the legs | Emergency assessment | No | Call 112 or go to an emergency department |
Not sure whether you need a bone density scan? A doctor can tell you in one consultation.
See available times →Treatment options for osteoporosis
What you can do yourself
- Exercise regularly: weight-bearing activity such as walking and climbing stairs, strength training, and balance exercises such as tai chi, which lower the risk of falls.
- Eat foods rich in calcium and vitamin D. Most healthy adults get enough calcium from a varied diet; people with osteoporosis may need more, so ask a doctor before taking supplements.
- Consider a daily vitamin D supplement in autumn and winter, as the NHS advises for all adults.
- Stop smoking and cut down on alcohol.
- Make your home safer: remove trip hazards, use good lighting, and have regular sight and hearing tests.
- Keep to a healthy weight; being underweight weakens bones.
Prescription treatment
A prescription is never issued without a consultation. Medicine is not always needed, and the choice depends on your fracture risk, age and sex. When it is needed, the doctor may prescribe a bisphosphonate such as alendronic acid, which slows bone breakdown and lowers the risk of fractures, often with calcium and vitamin D taken at a different time of day. Bisphosphonate tablets are swallowed on an empty stomach with a full glass of water, staying upright for 30 minutes and waiting before you eat or drink anything else; they usually take 6 to 12 months to work, and treatment may last 5 years or longer. If the doctor prescribes, use the prescription at a pharmacy near you.
Bone-strengthening treatments compared
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| Treatment | How it is given | What to know |
|---|---|---|
| Bisphosphonates: alendronic acid, risedronate, ibandronic acid, zoledronic acid | Tablets, a liquid, or an injection or drip | Usually the first choice; can irritate the food pipe or cause stomach pain |
| Denosumab | An injection every few months | For people who cannot take bisphosphonates, or with severe osteoporosis |
| Romosozumab | A monthly injection | For severe osteoporosis |
| Raloxifene | A daily tablet | Only for women after the menopause; can cause hot flushes and leg cramps, and may raise the risk of blood clots |
| Parathyroid hormone, such as teriparatide | A daily injection | Can increase bone density; for very low bone density when other treatments have not worked |
| HRT | Tablets, patches, gel or spray | Keeps bones strong and lowers fracture risk; used mainly for women with menopause symptoms or an early menopause |
Damage to the jawbone is a rare side effect, linked mostly to high-dose treatment for cancer given into a vein. If you have dental problems, a dental check-up before starting treatment may be advised.
What does not help
Stopping treatment without a review. Taking bisphosphonate tablets with food or with drinks other than water, or lying down soon after taking them. Avoiding exercise for fear of breaking a bone: the right exercise keeps bones strong and lowers the risk of falls.
Special situations
The menopause
Women lose bone quickly in the first years after the menopause. Women with an early menopause, before 45, are usually advised to take HRT or a hormonal contraceptive until at least the age of 51. For women aged 60 or under with menopause symptoms, the benefits of HRT usually outweigh the risks. The menopause page covers it.
Long-term steroid tablets
High-dose steroid tablets taken for more than 3 months raise the risk of osteoporosis. If you need them long term, ask about protecting your bones, especially if you also have rheumatoid arthritis.
Men
Men get osteoporosis too: 6.5 million men in the EU, the UK and Switzerland had it in 2019, and 1 in 5 men over 50 will break a bone because of it. Hormone-lowering treatment for prostate cancer, steroids and heavy drinking add to the risk.
After a broken bone
Painkillers, warm baths, cold packs and relaxation techniques can ease the pain while a fracture heals. A fracture after a minor fall is a reason to check your bones, even if you feel well.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When osteoporosis is treated online, and when you need in-person care
Treated online: working out your fracture risk, deciding whether you need a scan, explaining results, starting or reviewing tablets when it is right for you, side effects, HRT, and advice on exercise, diet and preventing falls.
In-person care: DEXA scans, X-rays, blood tests, injections and drips, and any fall with a suspected fracture.
When to get in-person care
Call 112 or go to an emergency department now for:
- a fall after which you cannot get up, stand or put weight on a leg
- a limb that looks deformed, or a bone pushing through the skin
- sudden severe back pain with numbness or weakness in the legs, or new problems controlling your bladder or bowels
- a hot, red, swollen joint with a fever
Get medical advice the same day for:
- sudden back pain after a minor fall, a lift or a cough, which can be a fracture in the spine
- pain in a bone after a minor fall that does not settle, even if you can walk
- new pain or difficulty when swallowing while taking bisphosphonate tablets
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your bones: say which bones you have broken and how, list your medicines, and have any scan or blood test results to hand.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s osteoporosis? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Back pain can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about osteoporosis
What is osteoporosis?
Osteoporosis is a condition in which bones lose density and become fragile, so they break more easily, most often at the wrist, the hip and the spine. It develops slowly over years and is most common in women after the menopause.
What are the signs of osteoporosis?
Often there are no signs of osteoporosis until a bone breaks. Warning signs are a bone broken after a minor fall, loss of height, a stooped posture, back pain from a collapsed bone in the spine, and a rib that breaks with a cough or sneeze.
Is osteoporosis painful?
Not on its own. Osteoporosis is usually painless until a bone breaks, but fractures in the spine are a common cause of long-term back pain.
What causes osteoporosis?
Osteoporosis comes from bone loss with age, which speeds up after the menopause. Steroid tablets for more than 3 months, an early menopause, a family history, low body weight, smoking, heavy drinking, little exercise and some conditions and medicines raise the risk.
Is osteoporosis hereditary?
Partly. A family history of osteoporosis raises your risk, especially a parent who broke a hip, and doctors ask about it when they estimate your fracture risk. Lifestyle, medicines and other conditions still matter.
What is osteopenia?
Bone density that is lower than average for your age but not low enough to be osteoporosis: a DEXA T-score between -1 and -2.5. It does not always lead to osteoporosis, and treatment depends on your fracture risk.
How is osteoporosis diagnosed?
With a DEXA bone density scan, which is short and painless. Doctors usually estimate your fracture risk first with a tool such as FRAX, and a T-score below -2.5 means osteoporosis.
Can osteoporosis be reversed?
Osteoporosis cannot be fully reversed, but treatment lowers the risk of fractures. Most medicines slow bone breakdown and keep bone density steady, and parathyroid hormone can increase it. Exercise, calcium, vitamin D and not smoking help keep bones as strong as possible.
What is the life expectancy with osteoporosis?
With osteoporosis, the main risk to life comes from fractures, especially of the hip: up to 20 to 24% of people who break a hip die within a year. Treatment and preventing falls lower that risk.
How can I prevent osteoporosis?
To prevent osteoporosis, stay active with weight-bearing, strength and balance exercise, eat a diet with enough calcium and vitamin D, keep to a healthy weight, stop smoking and drink less alcohol.
What can I do at home to protect my bones with osteoporosis?
Do weight-bearing and strength exercise most days, such as brisk walking, stairs, dancing or resistance bands, plus balance work like tai chi, which cuts falls; eat calcium-rich food, dairy, leafy greens, tinned fish with bones, and take vitamin D in winter or as prescribed; stop smoking and keep alcohol low; and make the home fall-proof, with good lighting, no loose rugs, grab rails and sensible shoes. Take osteoporosis medicines exactly as directed, bisphosphonate tablets on an empty stomach with water while sitting upright.
How long do you take osteoporosis tablets?
Bisphosphonate tablets for osteoporosis usually take 6 to 12 months to work, and treatment may last 5 years or longer. A doctor reviews how long you need them; do not stop without a review.
Is osteopenia the same as osteoporosis?
No. Osteopenia means bone density that is lower than average for your age but not low enough to be osteoporosis. It does not always lead to osteoporosis, and whether you need treatment depends on how weak your bones are and on your risk of a fracture, which doctors estimate with a tool such as FRAX or QFracture from your age, sex, weight, earlier fractures, family history, medicines and other conditions. Exercise, calcium and vitamin D matter at both stages.
Can an online doctor treat osteoporosis?
Partly. For osteoporosis, a doctor can estimate your fracture risk, tell you whether you need a scan, explain the results and start or review treatment by video. The scan, X-rays and injections are in person.
- Osteoporosis, NHS, National Health Service (UK), reviewed 13 October 2022.
- Osteoporosis: treatment, NHS, National Health Service (UK), reviewed 13 October 2022.
- SCOPE 2021: a new scorecard for osteoporosis in Europe, Kanis JA, et al. Archives of Osteoporosis, 2021.
- Epidemiology of osteoporosis and fragility fractures, International Osteoporosis Foundation, updated 8 February 2024.
- Osteoporosis: symptoms and causes, Mayo Clinic (US), 17 December 2025.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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