When Bones Become Fragile: A Story of Prevention

Kumari was just going about her normal day at her shop when it happened. The 60-year-old woman was carefully climbing down the stairs when she lost her footing and fell. While she was grateful to escape serious head, neck, or back injuries, the sharp pain in her left wrist told a different story.

At the hospital, doctors confirmed what the tell-tale deformity suggested – Kumari had suffered a Colles fracture, where her wrist bone was pushed backward, creating a distinctive "dinner fork" appearance. The medical team quickly applied a plaster cast below her elbow to immobilize the injury and allow proper healing.

But Kumari's story raises an important question that affects millions of people worldwide: Could this fracture have been prevented?

The Hidden Culprit: Osteoporosis

What happened to Kumari wasn't just bad luck. Her fracture was what doctors call a "fragility fracture" – a break that occurs from minimal trauma, like a simple fall from standing height. These fractures commonly affect the wrist, spine, and hip, and they're often the first sign of a silent condition called osteoporosis.

Osteoporosis literally means "porous bones." It's a condition where bones gradually lose their density and strength, becoming fragile and prone to breaking. The frightening reality is that this bone loss happens quietly over years, with no obvious symptoms until that first fracture occurs.

Years earlier, Kumari had fractured her ankle in what seemed like a minor twisting injury. At that time, her doctor had prescribed vitamin D supplements after discovering her bones were "too thin." This was actually an early warning sign that her bone health was already compromised.

A Growing Concern in Our Community

In Sri Lanka, as our population ages, osteoporosis is becoming an increasingly serious health issue. The condition is more common than many people realize, partly because it often goes undiagnosed and untested until after a fracture occurs.

Several factors contribute to weak bones in our population:

Nutritional deficiencies are surprisingly common. Many people don't get enough calcium in their diet, and vitamin D deficiency is widespread – more than we might expect in our sunny climate. Inadequate protein intake also weakens our bones over time.

Lifestyle factors play a crucial role. Smoking, excessive alcohol consumption, and a sedentary lifestyle all contribute to bone loss. Additionally, certain medical conditions like diabetes and rheumatoid arthritis can accelerate the process.

Age-related changes compound the problem. As we get older, we naturally lose muscle mass and balance, making falls more likely. Poor vision and general frailty further increase fracture risk.

The True Cost of Fragile Bones

The impact of osteoporotic fractures extends far beyond the initial injury. These breaks can dramatically reduce quality of life, leading to chronic pain, loss of independence, and significant medical expenses.

Hip fractures are particularly devastating. Many patients become bedridden, leading to complications like blood clots, pneumonia, and muscle wasting. The surgical procedures and prosthetics required are often expensive and may be financially out of reach for many families. But perhaps most importantly, these fractures are often preventable with the right approach.

Building Strong Bones: Your Defense Strategy

The good news is that there's much you can do to protect your bone health:

Eat for strong bones. Include plenty of calcium-rich foods like dairy products, leafy greens, and small fish with soft bones. Don't forget protein – your bones need it to stay strong. A well-balanced diet with adequate vitamins and minerals forms the foundation of bone health.

Stay active. Regular physical activity, especially weight-bearing exercises like walking, dancing, or climbing stairs, helps maintain bone density. Strength training and resistance exercises are particularly beneficial. Balance exercises can help prevent falls.

Make healthy choices. If you smoke, quit. Limit alcohol consumption. These habits directly damage your bones and increase fracture risk.

Manage your health conditions. If you have diabetes, rheumatoid arthritis, or other chronic conditions, work with your doctor to keep them well-controlled.

When to Seek Help

Doctors can assess your fracture risk using tools like the FRAX calculator, which considers your age, gender, medical history, and lifestyle factors. For a more detailed assessment, a DEXA scan can measure your bone density directly.

If your bone density is significantly low (a T-score of -2.5 or below), your doctor may recommend medications like bisphosphonates. These drugs help prevent further bone loss and can significantly reduce fracture risk. While they require careful administration – some must be taken while sitting upright and on an empty stomach – they can be highly effective.

Vitamin D and calcium supplements may also be prescribed to ensure your body has the building blocks it needs for strong bones. For women after menopause, hormone replacement therapy might be recommended to help maintain bone density.

Could Kumari's Story Have Been Different?

Looking back at Kumari's case, the warning signs were there. Her previous ankle fracture and thin bones should have prompted a comprehensive bone health assessment. Had her fracture risk been calculated and a DEXA scan performed earlier, appropriate treatment could have been started to strengthen her bones before this wrist fracture occurred.

Your Bones, Your Future

Kumari's story serves as a reminder that bone health isn't something to think about only after a fracture occurs. It's an investment in your future mobility and independence.

If you're over 50, have a family history of fractures, or have risk factors for osteoporosis, talk to your doctor about bone health screening. Simple lifestyle changes started today can help ensure that your bones remain strong enough to support an active, independent life for years to come.

Remember: the best time to start protecting your bones was 20 years ago. The second-best time is now.